Computer-simulated phacoemulsification1 , *1

Laurell, Carl‐Gustaf; Söderberg, Per G.; Nordh, Leif; Skarman, Eva; Nordqvist, Per

doi:10.1016/j.ophtha.2003.06.023

Cited by 55 publications

(11 citation statements)

References 16 publications

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“…The idea of using a virtual guidance system coupled with performance parameters in a virtual surgical simulator is not entirely new. Our findings reveal three other VR simulators in the literature [ 8 – 10 , 16 ], of which two have been commercialized at some point in the early development stages. To the best of our knowledge, none of these simulators simulate completely all four main procedures of the cataract surgery.…”

Section: Discussionsupporting

confidence: 52%

“…They however differ in the breadth and depth of assessment. As mentioned earlier, the performance index or parameters of the simulators in [ 8 – 10 ] were limited to either the capsulorhexis or the phacoemulsification procedures only. The final simulator by [ 16 ] extended the application of performance parameters to three out of four main procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Our results concur with previously obtained findings. The simulator developed in [ 10 , 13 ] incorporated performance indices to characterize the performance of users in the phacoemulsification (P) procedure. The evaluation of these performance indices were conducted separately on two different groups, naives [ 15 ] and experts [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…EYESi® [ 8 , 9 ] (VRmagic, Mannheim, Germany) and PhacoVision® [ 10 ] (Melerit Medical, Linkoping, Sweden) are the only two commercially available cataract surgery simulators. EYESi® allows for user assessment during the continuous curvilinear capsulorhexis procedure while PhacoVision® can assess users during the phacoemulsification training.…”

Section: Introductionmentioning

confidence: 99%

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Virtual phacoemulsification surgical simulation using visual guidance and performance parameters as a feasible proficiency assessment tool

Lam

Sundaraj

Sulaiman³

et al. 2016

BMC Ophthalmol

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BackgroundComputer based surgical training is believed to be capable of providing a controlled virtual environment for medical professionals to conduct standardized training or new experimental procedures on virtual human body parts, which are generated and visualised three-dimensionally on a digital display unit. The main objective of this study was to conduct virtual phacoemulsification cataract surgery to compare performance by users with different proficiency on a virtual reality platform equipped with a visual guidance system and a set of performance parameters.MethodsTen experienced ophthalmologists and six medical residents were invited to perform the virtual surgery of the four main phacoemulsification cataract surgery procedures – 1) corneal incision (CI), 2) capsulorhexis (C), 3) phacoemulsification (P), and 4) intraocular lens implantation (IOL). Each participant was required to perform the complete phacoemulsification cataract surgery using the simulator for three consecutive trials (a standardized 30-min session). The performance of the participants during the three trials was supported using a visual guidance system and evaluated by referring to a set of parameters that was implemented in the performance evaluation system of the simulator.ResultsSubjects with greater experience obtained significantly higher scores in all four main procedures – CI1 (ρ = 0.038), CI2 (ρ = 0.041), C1 (ρ = 0.032), P2 (ρ = 0.035) and IOL1 (ρ = 0.011). It was also found that experience improved the completion times in all modules – CI4 (ρ = 0.026), C4 (ρ = 0.018), P6 (ρ = 0.028) and IOL4 (ρ = 0.029). Positive correlation was observed between experience and anti-tremor – C2 (ρ = 0.026), P3 (ρ = 0.015), P4 (ρ = 0.042) and IOL2 (ρ = 0.048) and similarly with anti-rupture – CI3 (ρ = 0.013), C3 (ρ = 0.027), P5 (ρ = 0.021) and IOL3 (ρ = 0.041). No significant difference was observed between the groups with regards to P1 (ρ = 0.077).ConclusionsStatistical analysis of the results obtained from repetitive trials between two groups of users reveal that augmented virtual reality (VR) simulators have the potential and capability to be used as a feasible proficiency assessment tool for the complete four main procedures of phacoemulsification cataract surgery (ρ < 0.05), indicating the construct validity of the modules simulated with augmented visual guidance and assessed through performance parameters.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Virtual phacoemulsification surgical simulation using visual guidance and performance parameters as a feasible proficiency assessment tool

Lam

Sundaraj

Sulaiman³

et al. 2016

BMC Ophthalmol

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“…A variety of different virtual reality simulators have also been described, including three models for cataract surgery [ 52 – 54 ]; five for vitreoretinal surgery [ 55 – 59 ]; one for endoscopic endonasal surgery [ 60 ]; two for general ophthalmic surgery [ 61 , 62 ]; 1 for ophthalmic anaesthesia [ 63 ]; 1 on ocular ultrasound [ 64 ]; and 1 for indirect ophthalmoscopy [ 54 ]. However, these have all been stand-alone reports with limited evidence of content validity only (scores of 0 or 1).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of simulation-based training tools for technical and non-technical skills in ophthalmology

Lee

Raison

Lau

et al. 2020

Eye

104

100

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To evaluate all simulation models for ophthalmology technical and non-technical skills training and the strength of evidence to support their validity and effectiveness. A systematic search was performed using PubMed and Embase for studies published from inception to 01/07/2019. Studies were analysed according to the training modality: virtual reality; wet-lab; dry-lab models; e-learning. The educational impact of studies was evaluated using Messick’s validity framework and McGaghie’s model of translational outcomes for evaluating effectiveness. One hundred and thirty-one studies were included in this review, with 93 different simulators described. Fifty-three studies were based on virtual reality tools; 47 on wet-lab models; 26 on dry-lab models; 5 on e-learning. Only two studies provided evidence for all five sources of validity assessment. Models with the strongest validity evidence were the Eyesi Surgical, Eyesi Direct Ophthalmoscope and Eye Surgical Skills Assessment Test. Effectiveness ratings for simulator models were mostly limited to level 2 (contained effects) with the exception of the Sophocle vitreoretinal surgery simulator, which was shown at level 3 (downstream effects), and the Eyesi at level 5 (target effects) for cataract surgery. A wide range of models have been described but only the Eyesi has undergone comprehensive investigation. The main weakness is in the poor quality of study design, with a predominance of descriptive reports showing limited validity evidence and few studies investigating the effects of simulation training on patient outcomes. More robust research is needed to enable effective implementation of simulation tools into current training curriculums.

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Assessing Surgical Competence in Ophthalmology Training Programs

O’Day¹

2007

Arch Ophthalmol

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Computer-simulated phacoemulsification1 , *1

Cited by 55 publications

References 16 publications

Virtual phacoemulsification surgical simulation using visual guidance and performance parameters as a feasible proficiency assessment tool

Virtual phacoemulsification surgical simulation using visual guidance and performance parameters as a feasible proficiency assessment tool

A systematic review of simulation-based training tools for technical and non-technical skills in ophthalmology

Assessing Surgical Competence in Ophthalmology Training Programs

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