title: Virtual vitreoretinal surgical simulator as a training tool.
abstract: OBJECTIVE
  To demonstrate the feasibility and potential applicability of a virtual reality simulator for vitreoretinal surgery as a training and/or assessment tool.
  
  
  METHODS
  The subjects of this study included medical students, ophthalmologic residents, and trained vitreoretinal surgeons. There were three study groups. Group I comprised 22 subjects who performed a navigation task. The time to complete the task was recorded. The relationship between the completion time, experience, and stereopsis was evaluated. Group II included 6 subjects who consecutively performed the navigation task to evaluate their learning curve. Group III included 16 subjects who performed the membrane peeling task. The number of retinal contacts and the completion time were recorded. The relationship between experience and stereopsis with the number of contacts and the completion time were evaluated.
  
  
  RESULTS
  The average completion time in Group I for students, residents, and trained surgeons was 121.6, 92.5, and 70.6 seconds. There was a significant difference between students and trained surgeons (P = 0.004). In Group II, there was a significant decrease in the completion time with training (P = 0.001). In Group III, the average completion time for students, residents, and trained surgeons was 197, 144, and 118.2 seconds; the respective number of retinal contacts was 14, 8, and 3. There was a significant difference between students and residents (P = 0.05) and between residents and trained surgeons (P = 0.003) for the average completion time in Group III. There was a significant difference between students and trained surgeons (P = 0.003) for the number of contacts per average time and between students and residents (P = 0.05). There was a significant inverse correlation between stereopsis vision score and completion time in Group I and number of contacts per average time (P = 0.0004 and P = 0.01, respectively).
  
  
  CONCLUSIONS
  This study demonstrates potential applications of a vitreoretinal surgical simulator as a training and skills assessment tool for novice, inexperienced, and trained surgeons. A simulator can be used to teach specific techniques and train surgeons.
authors.affiliation: Doheny Retina Institute at the Doheny Eye Institute, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, USA.
authors.forename: Juliana V
authors.initials: JV
authors.lastname: Rossi
authors.forename: Dinesh
authors.initials: D
authors.lastname: Verma
authors.forename: Gildo Y
authors.initials: GY
authors.lastname: Fujii
authors.forename: Rohit R
authors.initials: RR
authors.lastname: Lakhanpal
authors.forename: Sue Lynn
authors.initials: SL
authors.lastname: Wu
authors.forename: Mark S
authors.initials: MS
authors.lastname: Humayun
authors.forename: Eugene
authors.initials: E
authors.lastname: De Juan
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D004501:Education, Medical / Q000379:methods*; D018961:Educational Technology / Q000295:instrumentation; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D013502:General Surgery; D006801:Humans; D007396:Internship and Residency; D008297:Male; D012160:Retina / Q000601:surgery*; D013337:Students, Medical; D014584:User-Computer Interface; D014822:Vitreous Body / Q000601:surgery*