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Objective: To evaluate motion tracking as an aid to a more objective assessment of ophthalmic microsurgical skill. Methods: In a cohort study, 3 groups of differing levels of surgical experience were assessed. The groups included novice surgeons (n = 10) with fewer than 5 previously performed corneal sutures, trainee surgeons (n=10) with 5 to 100 previously performed corneal sutures, and expert surgeons (n = 10) with more than 100 previously performed corneal sutures. The Imperial College Surgical Assessment Device was used for the objective assessment of surgical dexterity during corneal suturing. Each of the subjects used a 10-0 nylon suture in a 3-1-1 pattern on an artificial eye (Royal College of Ophthalmologists, London, England). The Imperial College Surgical Assessment Device measures 3-dimensional spatial vectors via electromagnetic sensors attached to the surgeon's fingers. The number of movements, path length for the respective movements, and time taken to complete the given task were recorded. Results: Highly statistically significant differences were found between the 3 grades of surgeon experience for time taken (PϽ.001), number of hand movements (PϽ.001), and path length of the hand movements (P=.002) to complete the given task. Conclusions: Motion analysis measured by this technology may be useful in the formal surgical training of residents and as an objective quantitative measure of dexterity.

Methods: An objective performance rating tool was devised. This instrument is comprised of standardized criteria with global rating and operation-specific components, each rated on a 5-point Likert scale. The total potential score was 100. Complete phacoemulsification cataract extraction operations were recorded through the operating microscope of surgeons with a range of experience (group A, Ͻ50 procedures; group B, 50-249 procedures; group C, 250-500 procedures, and group D, Ͼ500 procedures). These were then scored by independent expert reviewers masked to the grades of the surgeons. The U test was used to evaluate statistical significance. Results: We evaluated 38 surgical videotapes of 38 surgeons (group A, 11 surgeons; group B, 10 surgeons; group C, 5 surgeons; and group D, 12 surgeons). Mean±SD overall scores were as follows: group A, 32.0±5.3; group B, 55.0±12.6; group C, 89.0±4.7; and group D, 90.0±11.1. Statistically significant differences were found between groups A and B (P=.002) and groups B and C (P=.003), but not between groups C and D (PϾ.99). Conclusion: The Objective Structured Assessment of Cataract Surgical Skill scoring system seems to have construct validity with cataract surgery and, thus, may be valuable for assessing the surgical skills of junior trainees.

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