Aims To evaluate the role and efficacy of portable X-ray in reliably identifying retained suture needles in ophthalmologic surgical cases. Methods Ophthalmologic 10À0 nylon suture needles were placed into 10 of 20 porcine eyes positioned within the orbit of a human skull. Portable, plain film radiographs were taken of all eyes with a C-arm fluoroscopy machine. The films were reviewed by six ophthalmologists and six radiologists who were blinded to the presence or absence of needles, as well as the number of needles used in the protocol. The sensitivity and specificity of identifying retained suture needles by plain film radiographs were then analysed based on the results of the physicians' interpretations of the films. Results The overall sensitivity and specificity for physicians reviewing radiographs with suspected intraoperative suture needles were 54 and 77%, respectively. When looking separately at radiologists reviewing the films, the sensitivity was 57% and the specificity was 87%. Ophthalmologists reviewing the films identified retained needles less reliably with a sensitivity of 51% and a specificity of 67%. Conclusions Significant controversy exists regarding the reliability and utility of plain film radiography in identifying intraocular foreign bodies. This study demonstrates that the use of plain film radiographs to rule-out the presence of an intraocular surgical needle is neither a sensitive nor specific imaging modality.

Purpose The purpose of this study is to determine the translational effectiveness of surgical simulation as part of resident training on their performance on the task of casulorhexis during their first surgeries, as compared to traditional wetlab training. Methods Second Year Residents on rotation at the Veterans Affairs Boston Healthcare System were randomized to continuous capsulorrhexis training (CCC) in the traditional wetlab (n=10) with silicone eye versus on the EYESI surgical simulator (n=11). After completion of the training, residents' initial CCCs in the operating room on real patients were videorecorded. Videos were reviewed and scored by two anterior segment attending surgeons. Results Scores on 12 measures of performance were reasonably close in all cases; there was no statistical significance in any of the differences in individual scores. Correlation across all 12 measures of performance is 0.919 (p<.001). Overall score was calculated as the sum of the 12 individual performance scores. There was no significant difference in overall score between the two groups (p=.527). Conclusion Study suggests surgical simulator training when compared to traditional wetlab training is a safe, non‐risk method of preparing trainees to perform capsulorrhexis during their initial surgical experiences on real patients in the operating room.