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B. Feldman, R. Sachdeva, J. Ake, C. Geist; The Effects of Virtual Reality Training on the Performance of Corneal Laceration Repairs. Invest. Ophthalmol. Vis. Sci. 2007;48(13):789.
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To evaluate the effects of training with an ophthalmic surgical simulator on the acquisition of the microsurgical skills necessary to repair a corneal laceration
In a randomized controlled trial, 75 participants without prior microsurgical experience are being assessed performing a standardized ovine corneal laceration repair. The participants are randomized to either 3 hours of training on the EYESI ophthalmosurgical simulator or to a control group that receives 3 hours of video-enhanced microsurgical didactics. The EYESI training modules used in this study simulate microsurgery but do not directly simulate corneal laceration repair. Following training, both groups are then re-assessed performing the standardized ovine corneal laceration repair in order to evaluate interval improvement. Performance is evaluated using both an objective Corneal Laceration Repair Assessment (CLARA) and by blinded observers subjectively rating digitally recorded videos of the participant’s repair attempts.
Data from a pilot study involving 16 participants showed a trend towards greater improvement in laceration repair performance in the ophthalmosurgical simulator trained group as compared to the control group. The simulator group had greater improvement in 4 of the 6 CLARA categories (number of sutures thrown, number of re-entries, bite size score, and spacing score) and a 60% greater improvement in overall CLARA score (8.92 vs 5.63). None of these findings reached statistical significance. The sample size in the current follow-up study is powered to determine if these trends will reach statistical significance.
The pilot data suggests that training on the EYESI ophthalmosurgical simulator can accelerate the learning of corneal laceration repair. Since the virtual reality training in this study did not directly simulate suturing or laceration repair, the authors believe that participant improvement represents simulation-enhanced learning of general microsurgical psychomotor skills.
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