Abstract
Purpose :
To evaluate the phacoemulsification performance of non-experienced trainees using a virtual reality cataract surgery simulator.
Methods :
Ten medical students familiar with the anatomy and physiology of the eye, but naive to cataract surgery, were admitted to the study. Each subject was introduced to the simulator and then registered 40 simulations spanning 10 consecutive days with 4 simulations each day. Each simulation contains two phases, the capsulorhexis plus sculpting phase and the evacuation phase. The simulator automatically measured 38 variables during the simulation. All the variables were converted to performance index previously formulated by Söderberg et al. to assess the performance in both phases.
Results :
In the capsulorhexis plus sculpting phase the asymptote of the trainee overall performance index was, estimated as 95% CI, 0.9±0.7 and a number of simulations needed to reach 90% of the asymptote was 37±24, indicating that the performance asymptote of a naive trainee achieves approximately after 40 simulations. An average incidence of capsular damage was 30% for the first 10 simulations whereas 9% for the last 10 simulations. In the evacuation phase the trainee overall performance index of 1 which is equivalent to the reference performance index was reached within the first 5 simulations and quickly plateaued, and less performance variation and better performance correlated with more training on the simulator.
Conclusions :
A high-level performance asymptote occurs in the capsulorhexis plus sculpting phase after 40 simulations. In the evacuation phase performance asymptote can be reached at very early stage. Evacuation is less difficult than capsulorhexis plus sculpting.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.