Virtual Reality Simulation in Acquiring and Differentiating Basic Ophthalmic Microsurgical Skills

Solverson, Daniel J.; Mazzoli, Robert A.; Raymond, Wilfred W.; Nelson, Mark L.; Hansen, Elizabeth; Torres, Mark F.; Bhandari, Anuja; Hartranft, Craig D.

doi:10.1097/sih.0b013e318195419e

Cited by 74 publications

(79 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…High-fidelity virtual reality simulators such as the EyeSi (VR Magic, Mannheim, Germany) have an expanding evidence base supporting their utility in both cataract and vitreoretinal surgery, [9][10][11][12] and newer simulation devices including the Simulated Ocular Surgery models (Phillips Studio Products, www.simulatedocularsurgery.com/ about) also hold great promise. Although the EyeSi offers excellent simulation of routine surgical steps, it does not (at the time of writing) offer modules providing realistic simulation of complications such as vitreous loss.…”

Section: Discussionmentioning

confidence: 99%

Confidence of ophthalmology specialist trainees in the management of posterior capsule rupture and vitreous loss

Turnbull

Lash

2016

Eye

View full text Add to dashboard Cite

Purpose To ascertain ophthalmology trainee confidence in managing posterior capsule rupture (PCR) and vitreous loss. Methods An electronic survey was distributed to ophthalmology trainees in a single UK postgraduate training Deanery. Data collected included the stage of training, number of completed cataract operations, cumulative PCR rate, number of PCRs personally managed by the trainee, previous vitrectomy experience during vitreoretinal rotations, and attendance at advanced phacoemulsification courses. Trainees self-evaluated their confidence in managing PCR with vitreous loss, including the management of specific aspects of the procedure. Results Across training grades, only 9.1% (2/22) felt confident managing PCR without senior support. Respondents were most confident with fluidic parameters and IOL considerations, but 77.3% (17/22) lacked confidence in avoiding a dropped nucleus. Eleven respondents had completed 4350 cases (mean 576; range 383-1087). In this subgroup, mean cumulative PCR rate was 2.1% (range 0.9-4.9%), and trainees personally managed a mean 3.5 cases of PCR (range 1-7). Only 18.2% felt they could manage PCR and vitreous loss without senior support, and 45.5% stated they were not confident in avoiding a dropped nucleus. The most experienced trainee (1087 cases) had personally managed PCR just six times, and three trainees with 4350 cases had only managed PCR once each. Conclusions The Royal College of Ophthalmologists' requirement of 350 completed cases appears insufficient for independent cataract surgery, as opportunities to manage complications as a trainee are scarce. A competency-based assessment framework may be preferable, with a more targeted approach to training incorporating surgical simulation within the formal curriculum.

show abstract

Section: Discussionmentioning

confidence: 99%

Confidence of ophthalmology specialist trainees in the management of posterior capsule rupture and vitreous loss

Turnbull

Lash

2016

Eye

View full text Add to dashboard Cite

show abstract

“…The evidence for distributed training schedules is clear, although it is uncertain whether this means practice once a day or once a week. 11,12 Flexibility in accommodating training sessions will be needed when implementing this curriculum, but this should not detract from acquisition of skill as curriculum completion is based on the achievement of proficiency measures.…”

Section: Discussionmentioning

confidence: 99%

“…10 The aim of this study was to develop an evidencebased and stepwise VR training curriculum for acquisition of technical skills for PS. Although simulators have been evaluated as a part-task training platform for differentiating and developing basic ophthalmic microsurgical skills, 11,12 this is the first time that a phacoemulsification simulator has been subjected to a structured scientific method for curriculum development.…”

Section: Introductionmentioning

confidence: 99%

Development of a virtual reality training curriculum for phacoemulsification surgery

Spiteri

Aggarwal

Kersey

et al. 2013

Eye

View full text Add to dashboard Cite

Purpose Training within a proficiency-based virtual reality (VR) curriculum may reduce errors during real surgical procedures. This study used a scientific methodology to develop a VR training curriculum for phacoemulsification surgery (PS). Patients and methods Ten novice-(n) (performed o10 cataract operations), 10 intermediate-(i) (50-200), and 10 experienced-(e) (4500) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on the simulator-derived metrics for two abstract modules (four tasks) and three procedural modules (five tasks) on a high-fidelity VR simulator. Proficiency measures were based on the performance of experienced surgeons. Results Abstract modules demonstrated a 'ceiling effect' with construct validity established between groups (n) and (i) but not between groups (i) and (e)-Forceps 1 (46, 87, and 95; Po0.001). Increasing difficulty of task showed significantly reduced performance in (n) but minimal difference for (i) and (e)-Anti-tremor 4 (0, 51, and 59; Po0.001), Forceps 4 (11, 73, and 94; Po0.001). Procedural modules were found to be construct valid between groups (n) and (i) and between groups (i) and (e)-Lenscracking (0, 22, and 51; Po0.05) and Phacoquadrants (16, 53, and 87; Po0.05). This was also the case with Capsulorhexis (0, 19, and 63; Po0.05) with the performance decreasing in the (n) and (i) group but improving in the (e) group (0, 55, and 73; Po0.05) and (0, 48, and 76; Po0.05) as task difficulty increased. Conclusion Experienced/intermediate benchmark skill levels are defined allowing the development of a proficiency-based VR training curriculum for PS for novices using a structured scientific methodology.

show abstract

“…Sua aplicação como método de ensino para facoemulsificação inclui as etapas de capsulorrexe, hidrodissecção e delineação, emulsificação do núcleo e aspiração do córtex e já foi documentado e validado (7)(8)(9)(10)(11) . O treinamento prático com simuladores cirúrgicos (que vem sendo denominado "Dry-lab", em oposição ao tradicional "Wet-lab", onde são utilizados olhos de animais para o treinamento ex-perimental) já é realidade no Brasil.…”

Section: Editorialunclassified

Simulador cirúrgico e realidade virtual no ensino de cirurgia de catarata

Bisol¹,

Bisol²,

Rezende³

2012

Rev. bras.oftalmol.

View full text Add to dashboard Cite

Virtual Reality Simulation in Acquiring and Differentiating Basic Ophthalmic Microsurgical Skills

Abstract: VR simulator performance can be used as a gated, quantifiable performance goal to expert-level benchmarks. The EyeSi is a valid part-task training platform that may help develop novice surgeon dexterity to expert surgeon levels.

Cited by 74 publications

References 15 publications

Confidence of ophthalmology specialist trainees in the management of posterior capsule rupture and vitreous loss

Confidence of ophthalmology specialist trainees in the management of posterior capsule rupture and vitreous loss

Development of a virtual reality training curriculum for phacoemulsification surgery

Simulador cirúrgico e realidade virtual no ensino de cirurgia de catarata

Contact Info

Product

Resources

About