Stereoacuity and intraocular surgical skill: effect of stereoacuity level on virtual reality intraocular surgical performance

Authors: Madeleine Selvander, MD, Peter Åsman, PhD.

Publication: J Cataract Refract Surg. 2011 Dec; 37(12):2188-93. doi: 10.1016/j.jcrs.2011.05.048.



To evaluate the effect of stereoacuity on various intraocular surgical skills in inexperienced medical students using a virtual reality intraocular surgical simulator.


Department of Clinical Sciences, Malmö: Ophthalmology, Skåne University Hospital, Malmö, Sweden.


Comparative case series.


Ninth-semester medical students performed 1 iteration on each of the following 3 cataract training modules: navigation, forceps, and capsulorhexis. Before the simulator training, the trainees received standardized instructions and were allowed to perform 1 training round on the cataract navigation training module. After completion of the training, the level of stereoacuity was measured using TNO charts. Surgical performance for each task was measured, and performance parameter scores were recorded.


The study included 70 students. The simulator performance score correlated with the level of stereoacuity for the navigation training module (Spearman r = 0.377, P=.001) and forceps training module (Spearman r = 0.306, P=.01), showing a gradual increase in surgical performance with increasing stereoacuity. No such relationship was found for the capsulorhexis module (Spearman r = 0.18, P=.136).


A gradual detrimental effect on initial intraocular surgical skill with decreasing stereoacuity was shown. This calls for studies of the impact of deficient stereopsis on long-term training effects.

Financial Disclosure

Neither author has a financial or proprietary interest in any material or method mentioned.