Department of Ophthalmology, Torbay General Hospital, Torquay, UK.
Graefes Arch Clin Exp Ophthalmol. 2011 Jan;249(1):77-81. doi: 10.1007/s00417-010-1531-6. Epub 2010 Oct 2.
To determine the effect of fatigue on intraocular surgical performance using a virtual reality simulator.
Seven experienced ophthalmic surgeons were recruited. The first set of data collection was immediately before a live theatre session. Each surgeon received a standardized orientation to a virtual reality cataract surgery simulator (Eyesi©, VRmagic, Mannheim, Germany). All surgeons then completed ten attempts on level-four forceps module. The parameters recorded were total score, total time, total time score, corneal injury score, lens injury score, odometer score, and operating without red reflex score. To reduce the effect of the learning curve, each surgeon had a "plateau" score calculated for every parameter, which was the average of their final four attempts. The surgeons then returned immediately after their scheduled theatre lists to complete a further ten attempts on the same module and similar parameters were recorded.
Following routine theatre lists, simulator parameters slightly improved, with only the total score (97.28 to 98.57, p = 0.028) and total time (44 s to 35 s, p = 0.033) being statistically significant. The mean theatre list operating time was 197 min (SD ± 23.60).
No detrimental effect of fatigue was demonstrated following a routine operating list. The study provides a template for further assessments of fatigue in high-volume cataract surgery lists.
使用虚拟现实模拟器确定疲劳对眼内手术操作的影响。
招募了 7 名有经验的眼科医生。第一组数据采集是在现场手术前立即进行的。每位医生都接受了虚拟现实白内障手术模拟器（Eyesi©，VRmagic，曼海姆，德国）的标准化培训。然后，所有医生都完成了四级钳子模块的 10 次尝试。记录的参数包括总得分、总时间、总时间得分、角膜损伤得分、晶状体损伤得分、里程得分和无红光反射操作得分。为了减少学习曲线的影响，每位医生的每个参数都计算了一个“平台”得分，即最后四次尝试的平均值。然后，医生们在预定的手术名单后立即返回，在同一模块上再完成 10 次尝试，并记录类似的参数。
在完成常规手术名单后，模拟器参数略有改善，只有总得分（97.28 至 98.57，p = 0.028）和总时间（44 秒至 35 秒，p = 0.033）具有统计学意义。平均手术时间为 197 分钟（标准差 ± 23.60）。
在常规手术名单后，没有显示出疲劳的不利影响。该研究为进一步评估高容量白内障手术名单中的疲劳提供了模板。
