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NATICK, Mass. – Practice is key to improving accuracy and competency. This is the idea behind a device that enables warfighters to repeatedly practice an eyesight-saving surgery called lateral canthotomy and cantholysis, or LCC. DEVCOM SC oversaw the development of the system, which was created under a Small Business Innovation Research, or SBIR, agreement. The system has now been transferred to the commercial market.
“Eye injures can occur during combat, and many eye injuries can cause pressure to build behind the eye,” said Mark Mazzeo, a science and technology manager at DEVCOM SC’s site in Orlando, Florida. “This increase in pressure reduces blood flow to the retina and the optic nerve, which can lead to blindness if not treated within about 90 minutes. LCC is a surgical procedure that can release this pressure buildup. If it is performed quickly and correctly, it can save a Soldier’s eyesight.”
Previous training methods did not allow for much repetition, one of the keys to developing competence.
“Before this SBIR effort, the warfighter had to rely on a combination of didactic instruction and animal models to become familiar and confident performing this procedure,” said Mazzeo. “These methods are less than ideal because they don’t allow multiple attempts to practice the procedure.”
With the system developed under the SBIR, the warfighter can become competent performing LCC surgery by practicing repeatedly on a realistic replica of the human eye. The system is a trainer that features replaceable eye inserts.
“The original SBIR topic for this project was started after discussions with instructors at the Tactical Combat Medical Care (TCMC) center at Joint Base San Antonio,” said Mazzeo. “The instructors at TCMC asked for a realistic, low-cost, tabletop task trainer to include as a module in their trauma course.”
System development involved rigorous research.
Mazzeo explained that “over the course of the research, more than 1,000 participants practiced the procedure across 19 different training sites.”
“This project took time to accurately replicate the anatomy and physiology of the human eye relevant to successful performance of the procedure, including key landmarks and tactile feedback,” said Mazzeo. “It also involved significant prototyping and optimization of the final design to minimize cost, and extensive user tests to ensure training effectiveness. With this system, the warfighter can practice the procedure on a realistic human eye multiple times to achieve confidence and competence.”
Research concluded in December 2022, and the final product continues to be used in many military and civilian medical training centers.
“The manufacturer continues to sell hundreds of replaceable eye inserts each month for courses taught at TCMC, as well as the tri-service Medical Education and Training Campus (METC), the American Society of Optometric Surgeons, the Uniformed Services University for Health Sciences (USUHS), Womack Army Medical Center, Blanchfield Army Community Hospital, and the Naval Expeditionary Medical Training Institute,” said Mazzeo.
Mazzeo found working with the research team and seeing the success of the system extremely rewarding.
“Working with the research team, military experts on ocular trauma, and all the participants in the study has been a life-changing experience,” said Mazzeo. “In 2022, most of the year I was traveling with the research team conducting user tests at military and civilian hospitals across the United States. Many participants knew of the procedure, but very few had ever performed it on a real patient. Some were reluctant. Data from over a thousand assessments showed mastery and increased confidence after 2-3 practice sessions.”
He is honored that his work benefits the warfighter. During a research meeting, Mazzeo learned about a Soldier overseas who had successfully performed the LCC procedure.
“When asked where he had learned the procedure, the Soldier said some researchers had a new training device for it and had showed him how to do it – it was us,” said Mazzeo. “I am extremely proud of this research, but I was never prouder than in that moment I first heard that story.”
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About DEVCOM Soldier Center: The DEVCOM Soldier Center is committed to discovering, developing, and advancing science and technology solutions that ensure America’s warfighters are optimized, protected, and lethal. DEVCOM Soldier Center supports all of the Army's Modernization efforts, with the Soldier Lethality and Synthetic Training Environment Cross Functional Teams being the DEVCOM Soldier Center’s chief areas of focus. The center’s science and engineering expertise are combined with collaborations with industry, DOD, and academia to advance Soldier and squad performance. The center supports the Army as it transforms from being adaptive to driving innovation to support a Multi-Domain Operations Capable Force of 2028 and a MDO Ready Force of 2035. DEVCOM Soldier Center is constantly working to strengthen Soldiers’ performance to increase readiness and support for warfighters who are organized, trained, and equipped for prompt and sustainable ground combat.
STEM (Science, Technology, Engineering, and Math) outreach and mentoring the next generation of scientists and engineers are also an important part of the mission of DEVCOM Soldier Center. The mentoring of students by Army scientists and engineers benefits the students and their communities. It also increases young people's awareness of potential Army job opportunities and helps provide the Army with potential new talent, helping to fuel innovative ideas that benefit the nation's warfighters and the nation as a whole.
DEVCOM Soldier Center is part of DEVCOM. Through collaboration across the command's core technical competencies, DEVCOM leads in the discovery, development and delivery of the technology-based capabilities required to make Soldiers more lethal to win our nation's wars and come home safely. DEVCOM is a major subordinate command of the U.S. Army Futures Command.
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