Impact of simulator training on resident cataract surgery

Authors: Pokroy R, Du E, Alzaga A, Khodadadeh S, Steen D, Bachynski B, Edwards P.

Publication: Graefes Arch Clin Exp Ophthalmol. 2013 Mar;251(3):777-81.



Virtual reality surgery simulation training improves resident performance as measured by the simulator itself and wet-lab performance. This study aims to determine whether virtual surgery simulator training improves actual resident cataract surgery performance.


The first 50 phacoemulsification cases of 20 residents, at a single residency program (Henry Ford Hospital), were retrospectively compared as two groups: before (2007–8) and after (2009–10) introduction of the Eyesi virtual surgery simulator to the surgical training program. Primary outcomes were the incidence of posterior capsule tears and operation duration. All residents received traditional didactic and wet-lab training. Instructor surgeons were surveyed for their impression of the simulator’s contribution to resident surgical training.


The nonsimulator and simulator groups each comprised 500 cases with 40 and 35 posterior capsule tears respectively. Capsular tear rates for the nonsimulator and simulator groups were 8.8% and 10% respectively for the first 25 cases, and 7.2% and 3.6% (P = 0.11) respectively for cases 26 through 50 . The percentage of long cases (defined as >40 min) for cases 10 through 50 was 42.3% and 32.4% (P = 0.005) for the nonsimulator and simulator groups respectively.


Virtual reality surgical simulator training mildly shortens the learning curve for the first 50 phacoemulsification cases. The less adept residents appear to benefit most.