Cost analysis of objective resident cataract surgery assessments

Authors: Kiran Nandigam, MBA, Jonathan Soh, BS, William G. Gensheimer, MD, Ahmed Ghazi, MD, MSc, Yousuf M. Khalifa, MD.

Publication: Journal of Cataract & Refractive Surgery, Volume 41, Issue 5, May 2015.



To compare 8 ophthalmology resident surgical training tools to determine which is most cost effective.


University of Rochester Medical Center, Rochester, New York, USA.


Retrospective evaluation of technology.


A cost-analysis model was created to compile all relevant costs in running each tool in a medium-sized ophthalmology program. Quantitative cost estimates were obtained based on cost of tools, cost of time in evaluations, and supply and maintenance costs.


For wet laboratory simulation, Eyesi was the least expensive cataract surgery simulation method; however, it is only capable of evaluating simulated cataract surgery rehearsal and requires supplementation with other evaluative methods for operating room performance and for noncataract wet lab training and evaluation. The most expensive training tool was the Eye Surgical Skills Assessment Test (ESSAT). The 2 most affordable methods for resident evaluation in operating room performance were the Objective Assessment of Skills in Intraocular Surgery (OASIS) and Global Rating Assessment of Skills in Intraocular Surgery (GRASIS).


Cost-based analysis of ophthalmology resident surgical training tools are needed so residency programs can implement tools that are valid, reliable, objective, and cost effective. There is no perfect training system at this time.