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Surgical Simulation Training Reduces Intraoperative Cataract Surgery Complications Among Residents

Staropoli, Patrick, C., MD; Gregori, Ninel, Z., MD; Junk, Anna, K., MD; Galor, Anat, MD; Goldhardt, Raquel, MD; Goldhagen, Brian, E., MD; Shi, Wei, MS; Feuer, William, MS

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: February 2018 - Volume 13 - Issue 1 - p 11–15
doi: 10.1097/SIH.0000000000000255
Empirical Investigations

Introduction This retrospective consecutive case series examined whether training on a surgical simulator reduces intraoperative complication rates among novice ophthalmology residents learning cataract surgery.

Methods Beginning July 2014, training on the Eyesi simulator became mandatory for novice postgraduate year 3 ophthalmology residents before live cataract surgery at our institution. Complication rates of the 11 simulator-trained residents (study group) were compared with their immediate 11 simulator-naive predecessors (comparison group). Only straightforward cataract cases (according to standardized preoperative criteria) where postgraduate year 3 residents served as the primary surgeon were included. Complication data were obtained from Morbidity and Mortality records and compared using Fisher exact test. A survey was administered to the residents to gauge the perceived utility of simulation training.

Results The simulator-trained group (n = 501 cataract cases) and the simulator-naive comparison group (n = 454 cases) were analyzed. The complication rate in the simulator group was 2.4% compared with 5.1% in the comparison group (P = 0.037, Fisher exact test). Both the mean posterior capsule tear rate and vitreous prolapse rate in the simulator group were 2.2% compared with 4.8% in the comparison group (P = 0.032, Fisher exact test). The survey had a response rate of 100% (11/11), and 91% (10/11) of respondents felt that the training was “extremely worthwhile” and should be mandatory.

Conclusions The addition of surgical simulation training was associated with a significantly reduced rate of complications, including posterior capsule tears and vitreous prolapse, among novice postgraduate year 3 residents. There is a perceived utility among residents to incorporate virtual simulation into surgical training.

From the Miami Veterans Affairs Medical Center (P.C.S., N.Z.G., N.K.J., A.G., R.G., B.E.G.); and Department of Ophthalmology (P.C.S., N.Z.G., N.K.J., A.G., R.G., B.E.G., W.S., W.F.), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL.

Reprints: Ninel Z. Gregori, MD, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136 (e-mail: ngregori@med.miami.edu).

The authors have no proprietary interests in the materials described in the article. This study was supported by NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, and Department of Defense Grant W81XWH-13-1-0048, which supports the biostatisticians' work. The sponsor or funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the article.

The authors declare no conflict of interest.

© 2018 Society for Simulation in Healthcare