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Observational Study
. 2022 Nov;70(11):4018-4025.
doi: 10.4103/ijo.IJO_1600_22.

An objective evaluation of simulated surgical outcomes among surgical trainees using manual small-incision cataract surgery virtual reality simulator

R Sankarananthan  1 , R Senthil Prasad  1 , Tony Alex Koshy  1 , Padam Dharani  1 , Ashish Bacchav  1 , Van Charles Lansingh  1 , Chetan Ahiwalay  1 , K Balagiri  1 , Madhu Shekhar  1
Affiliations
Observational Study

An objective evaluation of simulated surgical outcomes among surgical trainees using manual small-incision cataract surgery virtual reality simulator

R Sankarananthan et al. Indian J Ophthalmol. 2022 Nov.

Abstract

Purpose: The purpose of this study was to evaluate trainee performance across six modules of a virtual reality (VR) simulator.

Methods: A retrospective observational study was conducted on 10 manual small-incision cataract surgery (MSICS) trainees who practiced cataract surgery on an MSICS VR simulator for one month. They were assessed in six major steps which included scleral groove, tunnel dissection, keratome entry, capsulorhexis, nucleus delivery, and intraocular lens (IOL) insertion under a trainer's supervision. The information included in their score metrics was collected, and their overall performance was evaluated.

Results: Thirty attempts were evaluated for scleral groove, tunnel dissection, and capsulorhexis and 15 attempts for keratome entry. Candidates had varied results in the dimensional aspects and their rates of complications with a mean satisfactory score of 3.1 ± 4.17, 6.8 ± 5.75, 5.8 ± 7.74, and 1.8 ± 2.57, respectively. Nucleus delivery (n = 5) had more of iris pull and IOL insertion (n = 5) had more of lost IOL as complications but both had a higher satisfactory outcome.

Conclusion: A VR simulator is a useful tool for training surgeons before their entry into live surgery. It is an effective method for evaluating objectively the structural characteristics of each phase in MSICS and their associated complications, helping them anticipate it earlier during live surgery by giving them a near real world experience.

Keywords: HelpMeSee simulator; MSICS; VR simulator; trainee surgeons.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(a) The HelpMeSee Eye Surgery Simulator with the handpieces which transmit the forces and sensation of touch to the fingertips of the operating surgeon. (b) The eyepiece view of the three-dimensional visuals when a trainee is performing capsulorhexis. (c) A screenshot of the sclero-corneal tunnel performance data that the simulator provides after every attempt. Note the scoring system based on the errors and performance data; the simulator can also assess if the attempt was satisfactory or not
See this image and copyright information in PMC

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