Thomsen Ann Sofia Skou, Smith Phillip, Subhi Yousif, Cour Morten la, Tang Lilian, Saleh George M, Konge Lars
Department of Ophthalmology, Rigshospitalet - Glostrup, Copenhagen, Denmark.
Copenhagen Academy for Medical Education and Simulation, Rigshospitalet, Copenhagen, Denmark.
Acta Ophthalmol. 2017 May;95(3):307-311. doi: 10.1111/aos.13275. Epub 2016 Sep 29.
To investigate the correlation in performance of cataract surgery between a virtual-reality simulator and real-life surgery using two objective assessment tools with evidence of validity.
Cataract surgeons with varying levels of experience were included in the study. All participants performed and videorecorded three standard cataract surgeries before completing a proficiency-based test on the EyeSi virtual-reality simulator. Standard cataract surgeries were defined as: (1) surgery performed under local anaesthesia, (2) patient age >60 years, and (3) visual acuity >1/60 preoperatively. A motion-tracking score was calculated by multiplying average path length and average number of movements from the three real-life surgical videos of full procedures. The EyeSi test consisted of five abstract and two procedural modules: intracapsular navigation, antitremor training, intracapsular antitremor training, forceps training, bimanual training, capsulorhexis and phaco divide and conquer.
Eleven surgeons were enrolled. After a designated warm-up period, the proficiency-based test on the EyeSi simulator was strongly correlated to real-life performance measured by motion-tracking software of cataract surgical videos with a Pearson correlation coefficient of -0.70 (p = 0.017).
Performance on the EyeSi simulator is significantly and highly correlated to real-life surgical performance. However, it is recommended that performance assessments are made using multiple data sources.
使用两种具有效度证据的客观评估工具，研究虚拟现实模拟器与现实手术中白内障手术操作表现之间的相关性。
纳入不同经验水平的白内障手术医生参与研究。所有参与者在完成EyeSi虚拟现实模拟器上基于熟练度的测试之前，进行并录制了三台标准白内障手术。标准白内障手术定义为：（1）在局部麻醉下进行的手术，（2）患者年龄>60岁，以及（3）术前视力>1/60。通过将三个完整手术的现实手术视频中的平均路径长度和平均移动次数相乘来计算运动跟踪分数。EyeSi测试包括五个抽象模块和两个操作模块：囊内导航、抗震颤训练、囊内抗震颤训练、镊子训练、双手操作训练、撕囊和超声乳化分而治之。
招募了11名外科医生。在指定的热身期后，EyeSi模拟器上基于熟练度的测试与通过白内障手术视频的运动跟踪软件测量的现实手术表现高度相关，皮尔逊相关系数为-0.70（p = 0.017）。
EyeSi模拟器上的表现与现实手术表现显著且高度相关。然而，建议使用多个数据源进行表现评估。
