title: The use of a virtual reality surgical simulator for cataract surgical skill assessment with 6 months of intervening operating room experience.
abstract: OBJECTIVE
  To evaluate a haptic-based simulator, MicroVisTouch™, as an assessment tool for capsulorhexis performance in cataract surgery. The study is a prospective, unmasked, nonrandomized dual academic institution study conducted at the Wilmer Eye Institute at Johns Hopkins Medical Center (Baltimore, MD, USA) and King Khaled Eye Specialist Hospital (Riyadh, Saudi Arabia).
  
  
  METHODS
  This prospective study evaluated capsulorhexis simulator performance in 78 ophthalmology residents in the US and Saudi Arabia in the first round of testing and 40 residents in a second round for follow-up.
  
  
  RESULTS
  Four variables (circularity, accuracy, fluency, and overall) were tested by the simulator and graded on a 0-100 scale. Circularity (42%), accuracy (55%), and fluency (3%) were compiled to give an overall score. Capsulorhexis performance was retested in the original cohort 6 months after baseline assessment. Average scores in all measured metrics demonstrated statistically significant improvement (except for circularity, which trended toward improvement) after baseline assessment. A reduction in standard deviation and improvement in process capability indices over the 6-month period was also observed.
  
  
  CONCLUSIONS
  An interval objective improvement in capsulorhexis skill on a haptic-enabled cataract surgery simulator was associated with intervening operating room experience. Further work investigating the role of formalized simulator training programs requiring independent simulator use must be studied to determine its usefulness as an evaluation tool.
authors: Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors: Shameema
authors: S
authors: Sikder
authors: College of Engineering, University of Illinois at Chicago, Chicago, IL, USA.
authors: Jia
authors: J
authors: Luo
authors: College of Engineering, University of Illinois at Chicago, Chicago, IL, USA.
authors: P Pat
authors: PP
authors: Banerjee
authors: College of Engineering, University of Illinois at Chicago, Chicago, IL, USA.
authors: Cristian
authors: C
authors: Luciano
authors: College of Engineering, University of Illinois at Chicago, Chicago, IL, USA.
authors: Patrick
authors: P
authors: Kania
authors: Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors: Jonathan C
authors: JC
authors: Song
authors: King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors: Eman S
authors: ES
authors: Kahtani
authors: Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA ; King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors: Deepak P
authors: DP
authors: Edward
authors: King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors: Abdul-Elah Al
authors: AE
authors: Towerki
keywords: cataract surgery; computer simulation; educational assessment; medical education; technology assessment
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