Significantly lower complication rates through virtual reality training of ophthalmic surgeons

Long-term study in Great Britain investigates the effect of simulator training on the surgical results of residents

Mannheim. A total of 38 percent fewer complications occurred in cataract operations performed by residents if they had trained on the »Eyesi Surgical« virtual reality simulator during their ophthalmic training. That is the result of a study currently published in the »British Journal of Ophthalmology« which investigated the effect of simulator training on the frequency of posterior lens capsule tears in Great Britain in the period from 2009 to 2016. For this purpose, a total of 17,831 cataract operations performed by 265 physicians in the first and second year of training were analyzed. In addition to better surgical results, the scientists in the team of John D. Ferris at the Gloucestershire Hospitals National Health Service Foundation Trust showed that use of a simulator also results in considerable cost savings.

In Great Britain, training on the Eyesi simulator was included in the training guidelines of the »Royal College of Ophthalmologists« in 2010. In order to investigate the effect of simulator-based training, the scientists used data records from the national database of the Royal College: since 2010, all cataract operations performed in hospitals of the state »National Health Service« have been systematically documented. Around 450 thousand cataract operations are performed each year in Great Britain, around 5 percent of these by residents in the first two years of training. Whereas the capsule tear rate during surgery decreased by 38 percent in the investigation period for residents who had trained on the simulator according to Ferris et al., it fell by only 3 percent in the comparison group without access to a simulator.

A tear in the posterior lens capsule during surgery can lead to serious further complications such as retinal detachment and thus to poorer post-operative vision for the patient. For hospitals, lower complication rates also represent a cost saving: for the investigated reduction of on average 280 capsule tears per year in cataract surgery alone, the scientists calculated savings of 600 thousand euros. According to the study outcome, the cost of the 20 Eyesi simulators would be recouped within 4 years.

Link to Publication

Ferris JD, Donachie PH, Johnston RL, et al. Br J Ophthalmol Epub ahead of print: 05/06/2019, doi:10.1136/bjophthalmol-2018-313817

Retrieved at

About Eyesi® Surgical

The Eyesi Surgical simulator is a high-end virtual reality simulator for training of intraocular surgery. The platform offers an OR-like training environment, where the surgeon sits in the usual position looking through a stereoscopic operation microscope and inserts original handheld instruments into the eye of a mannequin head. During simulation, all essential microscope and instrument functions are controlled via foot pedals. The Eyesi platform can be equipped with surgery interfaces for vitreoretinal or cataract surgery. The pre-installed curriculum of the simulator includes tasks with an increasing degree of difficulty – from basic surgical skills and procedures through to complication management. The performance evaluation takes into account different parameters such as instrument and microscope handling, surgical efficiency and tissue protection. This data is then stored in the system for analysis of training progress.

Download high-reslution images:

Resident training on Eyesi Surgical simulator
Resident training with Eyesi Surgical simulator (copyright VRmagic, photographer Rudolf Lachnith)
Resident training phacoemulsification on Eyesi Surgical simulator
Resident training phacoemulsification with Eyesi Surgical simulator (copyright VRmagic, photographer Rudolf Lachnith)


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