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AIM:To investigate the effectiveness of surgical simulator-based small-incision extracapsular cataract extraction training for young ophthalmologists.METHODS:Prospective and controlled study. A total of 48 young participants who had completed at least 3a standardized residency training or had obtained the attending certificate in the He Eye Specialist Hospital from 2020 to 2022 were enrolled. All the participants were randomly divided into simulator surgical operation training group(experimental group, n=24)and real animal eye operation training group(control group, n=24)after passing the theoretical training and assessment of small incision extracapsular cataract extraction. The participants in the experimental group and control group were trained with the surgical simulator and pig eyes respectively. After training, the overall effectiveness of training in both groups was rated using the simulator and pig eye operation was evaluated.RESULTS: The participants in the experimental group used less time than the participants in the control group on simulator assessment(all P<0.05). The scores of injecting viscoelastics during keratonyxis, nucleus delivery and hydrate the paracentesis site steps were not different on simulator assessment between the two groups(P>0.05). For the rest of the steps, the scores of experimental group were higher than those of the control group(all P<0.05). Participants in the experimental group had significantly higher scores than control group on pig eye operation assessment(all P<0.05). In the experimental group, the scores of the scleral groove dissection, tunnel dissection, continuous circular capsulorhexis, hydrodissection and hydro-prolapse and nucleus delivery steps had no significant difference between the surgical simulator and pig eye operation(P=0.068, 0.126, 0.960, 0.520, 0.206). The scores of injecting viscoelastics during keratonyxis, tunnel puncture into anterior chamber and hydrate the paracentesis site steps were significantly lower on simulator assessment than pig eye operation(P=0.007, 0.014, <0.01). The scores of the cortex removal and intraocular lens(IOL)implantation were significantly higher on simulator assessment than eye of real animal(P=0.035, <0.01).CONCLUSION:The application of surgical simulator on training small incision extracapsular cataract extraction skills for young ophthalmologists could significantly improve their skills in cataract surgery operation, providing a new mode and idea for the establishment of standardized cataract surgery training for young ophthalmologists.
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@#AIM: To investigate the application and effect of virtual-reality surgery exercise in minimally invasive cataract surgery training for ophthalmology residents.<p>METHODS:Twenty ophthalmology residents with equal seniority who had completed 3a standardized residency training in the Affiliated Eye Hospital of Nanjing Medical University from 2019 to 2021 were prospectively enrolled. After passing the theoretical examination, residents were randomly divided into virtual surgery exercise(Dry-lab)group(<i>n</i>=10)and real animal surgery exercise(Wet-lab)group(<i>n</i>=10). Dry-lab and Wet-lab group residents performed training using the Eye SI surgical simulator and pig eye respectively. At the end of the training, the overall training effects of the residents in both groups were rated using the Eye SI surgical simulator and the real pig eye operation, and the module training effects of the residents in both groups were rated using the virtual surgical simulator. Furthermore, a questionnaire survey was used to objectively evaluate the two training methods.<p>RESULTS:Residents in Dry-lab group had significantly higher total scores on both operation assessments,simulator assessment and real pig eye operation assessment than Wet-lab group(88.03±1.34 <i>vs</i> 80.35±2.87, 87.50±3.03 <i>vs</i> 77.60±5.62, 88.57±1.89 <i>vs</i> 83.10±3.22, all <i>P</i><0.01). The simulator module assessment results showed that the residents in Dry-lab group scored significantly better than Wet-lab group in terms of scores and completion time on each module(<i>P</i><0.01). The questionnaire results showed that Dry-lab group rated better than Wet-lab group in terms of the novelty of training, the proximity to the real surgical experience, the degree of help to the improvement of microsurgery skills, the confidence to perform real surgery, and the overall satisfaction of surgical training(<i>P</i><0.05). <p>CONCLUSION:Applying virtual-reality surgery exercise to cataract surgery skills training for ophthalmology residents can significantly improve the cataract skills, increase overall training satisfaction, and help residents enhance their confidence, psychological quality, decision-making, and processing ability during real surgery at the initial stage of practice. This provides a new standard and model for establishing a formal and standardized cataract surgery training system for ophthalmology residents.
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In view of the problems and shortcomings of the domestic ophthalmic microsurgery training system, drawing lessons from the training programs of famous ophthalmic centers abroad, our hospital has explored a set of hierarchical comprehensive training system for ophthalmic microsurgery. Through the four levels-eight scales microsurgery training, the hierarchical comprehensive training system organically integrates the multimedia theoretical teaching, the microscopic practice of Wet-Lab laboratory, microscopic training of surgical simulator and the clinical practice to achieve a better teaching effect in clinical practice, being widely praised by teachers and students.
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AlM: To discuss the application effect of surgical simulator to improve the microsurgical skills in junior ophthalmologist. METHODS: Lecture teaching, training in surgical simulator and operation in animal eyes were received in all these ophthalmologists. Results of the ability of operation in cataract surgery after this training were analyzed. RESULTS: After taught theory, students completed cataract surgical procedures on simulator and the mean test score was 75. 91 ± 6. 53 points. After trained on simulator repeatedly, the mean test score was 85. 57±4. 64 points. There was statistically significant difference ( P<0. 01) . During the third stage of practicing on animal eyes, the score was 89. 77 ± 7. 61 points, there was statistically significant difference compared with former two stages (P<0. 05).CONCLUSlON: Comprehensive training can improve microsurgical skills of junior ophthalmologist, but the long effect need to be observed.