The impact of extended reality simulators on ophthalmic surgical training and performance: A systematic review and meta-analysis

Theme: Glaucoma
What: Glaucoma
Part of: Glaucoma IV: New Tech / Glaucome IV: Nouvelles technologies
When: 6/1/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 801

Abstract

Purpose: Extended reality (XR) simulators, which encompasses virtual reality and augmented reality, has shown promise in enhancing surgical training. By replicating realistic surgical scenarios, XR provides trainees with a controlled learning and practice environment, enabling them to safely bolster their surgical skills and confidence. Despite significant advancements in XR technology, its specific role in ophthalmic surgical training remains unclear. This is the first comprehensive study delving into the use of XR for ophthalmic surgical training. Prior to this, no study had systematically summarized the efficacy and potential of XR in simulating ophthalmic surgery. 

Study design: Systematic review and meta-analysis. 

Methods: Eight electronic databases were searched, and resulting studies were assessed against predefined inclusion and exclusion criteria. Data extracted from selected studies underwent a random effects meta-analysis that examined the odds ratio (OR) for the common surgical complication, posterior capsular rupture (PCR). Risk of bias analyses were performed for each study using the Risk of Bias 2 and Risk of Bias in Non-randomized Studies of Interventions I.

Results: Of 1354 identified studies, 25 were included: nine (36%) retrospective, nine (36%) prospective, one (4%) cross-sectional, and six (24%) randomized controlled trials. Eight (32%) were included in the meta-analysis. Twenty-two (88%) studies used EyeSi, two (8%) HelpMeSee, and one (4%) MicroVis. Of these, two (8%) trained general microsurgery, one (4%) trained vitrectomy, two (8%) trained manual small incision cataract surgeries, 11 (44%) covered all phacoemulsification steps, eight (32%) capsulorhexis, and two (8%) cracking and chopping. The studies involved resident (19/25, 76%), attending (4/25, 16%), medical student (4/25, 16%), and fellow (1/25, 4%) trainees. The meta-analysis demonstrated a significant reduction in PCR after Eyesi practice, with no significant heterogeneity observed across studies (OR=0.71, 95% confidence interval=0.60-0.85, I²=9%). Sixteen studies (64%) had potential risks of bias, with two (8%) having critical, one (4%) having serious, and the rest (36%) having moderate risks.

Conclusions: This study establishes a correlation between XR training and enhanced surgical outcomes, particularly in reducing surgical complications. Future studies may consider exploring the effect of using XR and wet-lab training in conjunction, the application of XR for training the non-dominant hand, and its utility as a warm-up to surgical procedures. The results of this study have profound implications as they challenge the conventional ways of training and sets a precedent for change. Current training methods can be significantly enhanced by XR-based training. As a result, residency curricula may undergo revolutionary changes to incorporate XR as a mainstream tool.

Presenter(s)

Presenting Author: Lucy Yang

Additional Author(s):

Lucy Yang, Cumming School of Medicine, University of Calgary, Calgary AB

Abdullah Al-Ani, Division of Ophthalmology, Department of Surgery, University of Calgary, Calgary AB

Mohamed Bondok, Cumming School of Medicine, University of Calgary, Calgary AB

Patrick Gooi, Division of Ophthalmology, Department of Surgery, University of Calgary, Calgary AB

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