title: Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes.
abstract: The integration of swept-source optical coherence tomography (SS-OCT) into the operating microscope enables real-time, tissue-level three-dimensional (3D) imaging to aid in ophthalmic microsurgery. In this prospective randomized controlled study, we evaluated the impact of SS microscope-integrated OCT (MI-OCT) on ophthalmology residents' performance of ophthalmic microsurgical maneuvers.
  
  
  
  Fourteen ophthalmology residents from a single institution were stratified by year of training and randomized to perform four anterior segment surgical maneuvers on porcine eyes with (MI-OCT+) or without (MI-OCT-) direct intraoperative OCT guidance. Subsequently, both groups repeated the same maneuvers without MI-OCT feedback to test whether initial MI-OCT experience affected subsequent surgical performance. Finally, the MI-OCT- group was crossed over and allowed to repeat the same maneuvers with direct MI-OCT guidance. Each resident completed a survey at the completion of the study.
  
  
  
  With direct MI-OCT feedback, residents demonstrated enhanced performance in depth-based anterior segment maneuvers (corneal suture passes at 50% and 90% depth and corneal laceration repair) compared with the residents operating without MI-OCT. Microscope-integrated OCT+ residents continued to outperform the controls when both groups subsequently operated without MI-OCT. For clear corneal wound geometry, there was no statistically significant effect of MI-OCT as applied in this study. Overall, the resident surgeons rated their subjective experience of using MI-OCT very favorably.
  
  
  
  Microscope-integrated OCT feedback enhances performance of ophthalmology residents in select anterior segment surgical maneuvers. Microscope-integrated OCT represents a valuable tool in the surgical education of ophthalmology residents.
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States.
authors.forename: Bozho
authors.initials: B
authors.lastname: Todorich
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States.
authors.forename: Christine
authors.initials: C
authors.lastname: Shieh
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: DeSouza
authors.affiliation: Biomedical Engineering, Pratt School of Engineering Duke University, Durham, North Carolina, United States.
authors.forename: Oscar M
authors.initials: OM
authors.lastname: Carrasco-Zevallos
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States.
authors.forename: David L
authors.initials: DL
authors.lastname: Cunefare
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Stinnett
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States 2Biomedical Engineering, Pratt School of Engineering Duke University, Durham, North Carolina, United States.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Izatt
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States 2Biomedical Engineering, Pratt School of Engineering Duke University, Durham, North Carolina, United States.
authors.forename: Sina
authors.initials: S
authors.lastname: Farsiu
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States.
authors.forename: Privthi
authors.initials: P
authors.lastname: Mruthyunjaya
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States.
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Kuo
authors.affiliation: Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States 2Biomedical Engineering, Pratt School of Engineering Duke University, Durham, North Carolina, United States.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Toth
mesh_terms: D000869:Anterior Eye Segment / Q000601:surgery*; D002983:Clinical Competence; D005128:Eye Diseases / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D008853:Microscopy / Q000379:methods; D008866:Microsurgery / Q000193:education* / Q000379:methods; D016343:Monitoring, Intraoperative / Q000379:methods; D009885:Ophthalmology / Q000193:education*; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted / Q000193:education* / Q000379:methods; D041623:Tomography, Optical Coherence / Q000379:methods*