Abstract
Purpose :
Virtual simulators are thought to accelerate the learning curve of cataract surgery performed by ophthalmology residents. Our study hypothesized that the complication rates and surgical duration for resident cases decreased after implementing the virtual simulator training into our surgical rotation curriculum.
Methods :
We analyzed seven years of data, 1,279 eyes who underwent phacoemulsification cataract surgeries by 2nd and 3rd year ophthalmology resident surgeons at the Veterans Affairs Medical Center in Washington DC. Outcomes measured were surgical time for clear corneal and scleral tunnel phacoemulsification and complication rates before and after implementation of mandatory pre-rotation and in-rotation virtual cataract surgery simulator training. Data was analyzed using the unpaired t test and Chi square test.
Results :
Mean± SD surgical time in minutes (m) for clear corneal incision surgery was significantly shorter for 3rd year residents in the simulator training group 43.2 ±17 m compared to their pre-simulator training group 50.5±18 m (P = 0.0001). Surgical times were also significantly reduced in 2nd year residents for clear corneal (P=0.01) and scleral tunnel surgery in the simulator training group (P=0.0009) compared to cataract surgeries performed prior to simulator training. Results also showed a complication rate of 8.6% before simulator implementation and 2.9% after (P=0.00006). Similarly, the incidence of vitreous loss was 0.9% in the simulator trained group compared to 3.1% in the pre simulator training group (P=0.005).
Conclusions :
Our study shows that integration of mandatory surgical simulator training into the educational curriculum of resident physician cataract surgeons can significantly reduce phacoemulsification times and complication rates, regardless of surgeon experience and surgical technique used. We recommend the implementation of virtual simulator surgical training into the curriculum of ophthalmology residency to increase efficiency and safety of cataract surgery.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.