Performance index for virtual reality phacoemulsification surgery

We have developed a virtual reality (VR) simulator for phacoemulsification (phaco) surgery. The current work aimed at developing a performance index that characterizes the performance of an individual trainee. We recorded measurements of 28 response variables during three iterated surgical sessions in 9 subjects naive to cataract surgery and 6 experienced cataract surgeons, separately for the sculpting phase and the evacuation phase of phacoemulsification surgery. We further defined a specific performance index for a specific measurement variable and a total performance index for a specific trainee. The distribution function for the total performance index was relatively evenly distributed both for the sculpting and the evacuation phase indicating that parametric statistics can be used for comparison of total average performance indices for different groups in the future. The current total performance index for an individual considers all measurement variables included with the same weight. It is possible that a future development of the system will indicate that a better characterization of a trainee can be obtained if the various measurements variables are given specific weights. The currently developed total performance index for a trainee is statistically an independent observation of that particular trainee.

[1]  G. W. Wallace,et al.  Visual results and complications of phacoemulsification with intraocular lens implantation performed by ophthalmology residents. , 1992, Ophthalmology.

[2]  M S Wilson,et al.  MIST VR: a virtual reality trainer for laparoscopic surgery assesses performance. , 1997, Annals of the Royal College of Surgeons of England.

[3]  A. Gallagher,et al.  Virtual reality training leads to faster adaptation to the novel psychomotor restrictions encountered by laparoscopic surgeons , 2001, Surgical Endoscopy.

[4]  Lawrence,et al.  Phacoemulsification--a senior surgeon's learning curve. , 1994, Ophthalmic surgery.

[5]  Per Nordqvist,et al.  Virtual cataract surgery: clinical evaluation , 2003, SPIE BiOS.

[6]  R J Olson,et al.  Complications and results of phacoemulsification performed by residents , 1995, Journal of cataract and refractive surgery.

[7]  G. Ahlberg,et al.  Does training in a virtual reality simulator improve surgical performance? , 2001, Surgical Endoscopy And Other Interventional Techniques.

[8]  C. Laurell,et al.  Computer-simulated phacoemulsification. , 2004, Ophthalmology.

[9]  R. Burton,et al.  The phacoemulsification learning curve: Per-operative complications in the first 3000 cases of an experienced surgeon , 2000, Eye.

[10]  P McDonald,et al.  Training for surgeons after the year 2000 , 1998, Journal of the Royal Society of Medicine.

[11]  Per Nordqvist,et al.  Computer-simulated phacoemulsification , 2001, SPIE BiOS.

[12]  Per Nordqvist,et al.  Evaluation of response variables in computer-simulated virtual cataract surgery , 2006, SPIE BiOS.

[13]  M. Srinivasan,et al.  The initial complication rate of phacoemulsification in India. , 1997, Investigative ophthalmology & visual science.

[14]  Carl-Gustaf Laurell,et al.  Computer-simulated phacoemulsification improvements , 2002, SPIE BiOS.

[15]  David T. Ng,et al.  Intraoperative complications of 1000 phacoemulsification procedures: A prospective study , 1998, Journal of cataract and refractive surgery.

[16]  H C Seward,et al.  Phacoemulsification during the learning curve: Risk/benefit analysis , 1993, Eye.

[17]  P J Foster,et al.  Cataract surgery by junior ophthalmologists. , 1995, Eye.

[18]  C. Laurell,et al.  Virtual reality phacoemulsification: a comparison between skilled surgeons and students naive to cataract surgery , 2005 .

[19]  S Weghorst,et al.  Virtual Reality Simulators for Dermatologic Surgery: Measuring Their Validity as a Teaching Tool , 2001, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[20]  George L. Spaeth,et al.  Phacoemulsification-A Senior Surgeon's Learning Curve/COMMENT , 1994 .