Safety of nondominant-hand ophthalmic surgery.
OBJECTIVE
To establish the safety of nondominant-hand simulated intraocular surgery.


METHODS
Horizon Suite Simulation Centre, South Devon Foundation NHS Trust, Devon, United Kingdom.


METHODS
Cohort study.


METHODS
Physicians with no previous ophthalmic surgical experience completed an introductory program on the EyeSi ophthalmic surgical simulator to eliminate the learning curve. They then completed the validated level-4 forceps module 4 times with their dominant hand and then 4 times with their nondominant hand. Simulator total score, odometer movement, corneal injury, lens injury, and total time were recorded. Acuity (Snellen near) and stereoacuity (Frisby) were also recorded.


RESULTS
All 30 physicians showed good acuity (6/6 and N6 or better) and stereopsis (mean 35 seconds of arc). The total score was lower (mean 60.8 versus 65.6; P=.019), operating times were longer (mean 71.6 versus 70.0; P=.026), and lens injury was greater (mean 0.93 versus 0.79, P=.021) when operating with the nondominant hand than with operating with the dominant hand. Those with higher scores with the dominant hand had higher scores with their nondominant hand.


CONCLUSIONS
Simulated nondominant-hand ophthalmic surgery resulted in less efficient, less safe, and slower surgery. This observation was more marked in those with less skill with their dominant hand. This has practical implications for trainee and trainer if 1 surgeon is left handed and 1 right handed. It also suggests that a higher degree of competence with the dominant hand is required before performing nondominant-hand surgery.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned.
Ophthalmology Department, South Devon Foundation NHS Trust, Torbay, Devon, United Kingdom. jonathanpark@nhs.net
Jonathan
J
Park
Olayinka
O
Williams
Salman
S
Waqar
Neil
N
Modi
Thomas
T
Kersey
Tamsin
T
Sleep
D002387:Cataract Extraction; D002983:Clinical Competence; D003198:Computer Simulation; D003867:Depth Perception / Q000502:physiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006225:Hand; D006801:Humans; D008297:Male; D008866:Microsurgery; D011597:Psychomotor Performance / Q000502:physiology*; D014584:User-Computer Interface; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology