Genentech uses VR, presence to train eye surgeons

[Virtual reality and the sense of presence it evokes is used for a growing set of training applications including in health care; for anyone who has to get regular eye injections and/or knows people who do, this Wall Street Journal story about the use of VR to train surgeons to implant a new small device in the eye that replaces the injections is particularly interesting. –Matthew]

[Image: Genentech is training eye surgeons on a procedure treating an eye disease that affects more than 1 million Americans. Credit: Genetech.]

Genentech Uses Virtual Reality to Train Eye Surgeons

Adopts technology in clinical trial for eye-implant procedure

By Sara Castellanos
February. 6, 2019

Genentech, a division of Roche Holding AG, is using virtual reality as a training tool for eye surgeons in a clinical trial that executives expect will be the beginning of widespread use of the technology.

Over the past year, more than 150 surgeons have used VR to simulate a surgical procedure treating wet age-related macular degeneration, an eye disease that affects more than 1 million people age 50 and older in the U.S.

The surgery requires the implant in the eye of a device, roughly the size of a grain of rice, that continuously releases a drug for the treatment of the disease.

If the device in the clinical trial is approved by the Food and Drug Administration in a few years, Genentech expects to train the more than 2,200 retinal specialists in the U.S. Virtual reality will be a major component of that training in order for them to master the procedure, the company said.

“Historically, surgeons had to learn on patients. What we’re trying to do here is see all the possible permutations that can occur, in virtual reality, so that when [the surgeons] are actually doing this on a patient, they’re ready,” said Anthony Adamis, senior vice president of development innovation for Genentech.

In virtual reality, users wear headsets in which they can see digitized representations of the real world. Movements, such as turning one’s head, and other actions have outcomes within the digital representation.

Other industries outside of health care use virtual reality in training. United Parcel Service Inc., for example, is using virtual reality to simulate the experience of driving its iconic brown delivery trucks before new drivers hit the road. Walmart Inc. recently developed a management training program in which much of the training takes place in virtual reality.

Worldwide spending on virtual reality and augmented reality, which superimposes digital images onto a user’s view of the real world, is expected to reach nearly $20.4 billion this year, according to market intelligence firm International Data Corp. That’s up from an estimated $12.1 billion in 2018.

Genentech took inspiration from the commercial aviation sector, where flight has become safer in part because of simulated training, Dr. Adamis said.

Some of the VR training for eye surgeons in the clinical trial takes place at Genentech’s South San Francisco campus. The surgeons use a workstation that includes a virtual reality headset and a physical replica of the human eye and replicas of surgical tools. Surgeons are trained in virtual reality on how to implant the device that contains the drug and also how to refill the device. The surgeons can move the physical replicas of tools onto the physical replica of the human eye, which also appear digitized in the headset, to simulate the act of surgery.

The VR headsets and technology are provided by Germany-based VRmagic.

Genentech has invested “well over” $1 million over the past three years in virtual reality equipment and development of the surgical training program, said Christopher Brittain, interim global head of clinical ophthalmology for Genentech.

A 2017 study in Ophthalmology, the journal of the American Academy of Ophthalmology, showed that novice cataract surgeons showed significant improvement after training in virtual reality simulations.

Until the mid-2000s, there was treatment for wet age-related macular degeneration, but it only slowed the progression of the disease, which could result in eventual blindness. There was also no way to restore vision loss until the approval of a Genentech drug in 2006, when the rate of blindness from the disease dropped by about 50%, Dr. Brittain said. Current treatment requires eye injections as often as monthly.

If approved by the FDA, the surgical implant to treat the disease would go a long way in reducing the burden of having to visit the doctor monthly, which is why virtual reality surgical training is so critical, he said. “Virtual reality is really going to make sure that every surgeon is as ready as they possibly can be to perform these surgeries,” Dr. Brittain said.


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