&lt;title&gt;Computer-simulated phacoemulsification improvements&lt;/title&gt;

We have developed a virtual reality (VR) simulator for phacoemulsification surgery. The current work aimed at developing a relative performance index that characterizes the performance of an individual trainee. We recorded measurements of 28 response variables during three iterated surgical sessions in 9 experienced cataract surgeons, separately for the sculpting phase and the evacuation phase of phacoemulsification surgery and compared their outcome to that of a reference group of naive trainees. We defined an individual overall performance index, an individual class specific performance index and an individual variable specific performance index. We found that on an average the experienced surgeons performed at a lower level than a reference group of naive trainees but that this was particularly attributed to a few surgeons. When their overall performance index was further analyzed as class specific performance index and variable specific performance index it was found that the low level performance was attributed to a behavior that is acceptable for an experienced surgeon but not for a naive trainee. It was concluded that relative performance indices should use a reference group that corresponds to the measured individual since the definition of optimal surgery may vary among trainee groups depending on their level of experience.

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“…We have developed a VR phaco emulsification cataract surgery simulator [17][18][19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…We have developed a virtual reality phacoemulsification simulator, PhacoVision® [17][18][19][20]. The simulator consists a personal computer, simulation software and a surgeon interface.…”

Section: Introductionmentioning

confidence: 99%

Measuring performance in virtual reality phacoemulsification surgery

et al. 2008

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“…We have developed a VR phaco simulator [10][11][12][13][14]. The current study demonstrates that some of the response variables that we have identified for measurement of the performance during the simulation have enough precision to be useful in clinical evaluations.…”

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confidence: 92%

“…Studies of experienced surgeons have shown that the number of complications decreased exponentially reaching the asymptote after 400 [7] and 1000 cases respectively [8]. We have developed a virtual reality phaco simulator [10][11][12][13]. The simulator consists a personal computer, simulation software and a surgeon interface.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of response variables in computer-simulated virtual cataract surgery

et al. 2006

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We have developed a virtual reality (VR) simulator for phacoemulsification (phaco) surgery. The current work aimed at evaluating the precision in the estimation of response variables identified for measurement of the performance of VR phaco surgery. We identified 31 response variables measuring; the overall procedure, the foot pedal technique, the phacoemulsification technique, erroneous manipulation, and damage to ocular structures. Totally, 8 medical or optometry students with a good knowledge of ocular anatomy and physiology but naive to cataract surgery performed three sessions each of VR Phaco surgery. For measurement, the surgical procedure was divided into a sculpting phase and an evacuation phase. The 31 response variables were measured for each phase in all three sessions. The variance components for individuals and iterations of sessions within individuals were estimated with an analysis of variance assuming a hierarchal model. The consequences of estimated variabilities for sample size requirements were determined. It was found that generally there was more variability for iterated sessions within individuals for measurements of the sculpting phase than for measurements of the evacuation phase. This resulted in larger required sample sizes for detection of difference between independent groups or change within group, for the sculpting phase as compared to for the evacuation phase. It is concluded that several of the identified response variables can be measured with sufficient precision for evaluation of VR phaco surgery.

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“…We have developed a virtual reality phacoemulsification simulator, PhacoVision® [14][15][16][17]. The simulator consists a personal computer, simulation software and a surgeon interface.…”

Section: Introductionmentioning

confidence: 99%

Performance index for virtual reality phacoemulsification surgery

et al. 2007

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We have developed a virtual reality (VR) simulator for phacoemulsification (phaco) surgery. The current work aimed at developing a performance index that characterizes the performance of an individual trainee. We recorded measurements of 28 response variables during three iterated surgical sessions in 9 subjects naive to cataract surgery and 6 experienced cataract surgeons, separately for the sculpting phase and the evacuation phase of phacoemulsification surgery. We further defined a specific performance index for a specific measurement variable and a total performance index for a specific trainee. The distribution function for the total performance index was relatively evenly distributed both for the sculpting and the evacuation phase indicating that parametric statistics can be used for comparison of total average performance indices for different groups in the future. The current total performance index for an individual considers all measurement variables included with the same weight. It is possible that a future development of the system will indicate that a better characterization of a trainee can be obtained if the various measurements variables are given specific weights. The currently developed total performance index for a trainee is statistically an independent observation of that particular trainee.

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<title>Computer-simulated phacoemulsification improvements</title>

Cited by 10 publications

References 8 publications

Measuring performance in virtual reality phacoemulsification surgery

Measuring performance in virtual reality phacoemulsification surgery

Evaluation of response variables in computer-simulated virtual cataract surgery

Performance index for virtual reality phacoemulsification surgery

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