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Objective: To evaluate motion tracking as an aid to a more objective assessment of ophthalmic microsurgical skill. Methods: In a cohort study, 3 groups of differing levels of surgical experience were assessed. The groups included novice surgeons (n = 10) with fewer than 5 previously performed corneal sutures, trainee surgeons (n=10) with 5 to 100 previously performed corneal sutures, and expert surgeons (n = 10) with more than 100 previously performed corneal sutures. The Imperial College Surgical Assessment Device was used for the objective assessment of surgical dexterity during corneal suturing. Each of the subjects used a 10-0 nylon suture in a 3-1-1 pattern on an artificial eye (Royal College of Ophthalmologists, London, England). The Imperial College Surgical Assessment Device measures 3-dimensional spatial vectors via electromagnetic sensors attached to the surgeon's fingers. The number of movements, path length for the respective movements, and time taken to complete the given task were recorded. Results: Highly statistically significant differences were found between the 3 grades of surgeon experience for time taken (PϽ.001), number of hand movements (PϽ.001), and path length of the hand movements (P=.002) to complete the given task. Conclusions: Motion analysis measured by this technology may be useful in the formal surgical training of residents and as an objective quantitative measure of dexterity.

Methods: An objective performance rating tool was devised. This instrument is comprised of standardized criteria with global rating and operation-specific components, each rated on a 5-point Likert scale. The total potential score was 100. Complete phacoemulsification cataract extraction operations were recorded through the operating microscope of surgeons with a range of experience (group A, Ͻ50 procedures; group B, 50-249 procedures; group C, 250-500 procedures, and group D, Ͼ500 procedures). These were then scored by independent expert reviewers masked to the grades of the surgeons. The U test was used to evaluate statistical significance. Results: We evaluated 38 surgical videotapes of 38 surgeons (group A, 11 surgeons; group B, 10 surgeons; group C, 5 surgeons; and group D, 12 surgeons). Mean±SD overall scores were as follows: group A, 32.0±5.3; group B, 55.0±12.6; group C, 89.0±4.7; and group D, 90.0±11.1. Statistically significant differences were found between groups A and B (P=.002) and groups B and C (P=.003), but not between groups C and D (PϾ.99). Conclusion: The Objective Structured Assessment of Cataract Surgical Skill scoring system seems to have construct validity with cataract surgery and, thus, may be valuable for assessing the surgical skills of junior trainees.

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The findings provide the current frequency and distribution of eyelid BCCs in England, highlighting opportunities for health education and improving reporting and registration of events, and for informing service planning.

Purpose: To investigate the correlation in performance of cataract surgery between a virtualreality simulator and real-life surgery using two validated, objective assessment tools.Methods: Cataract surgeons with varying levels of experience were included in the study. All participants performed and video-recorded three standard cataract surgeries before completing a proficiency-based test on the EyeSi virtual-reality simulator. Standard cataract surgeries were defined as: 1) surgery performed under local anaesthesia, 2) patient age > 60 years, and 3) visual acuity > 1/60 pre-operatively. A motion-tracking score was calculated by multiplying average path length and average number of movements from the three real-life surgical videos of full procedures. The EyeSi test consisted of five abstract and two procedural modules: intracapsular navigation, antitremor training, intracapsular antitremor training, forceps training, bimanual training, capsulorhexis, and phaco divide and conquer. Results: Eleven surgeons were enrolled. After a designated warm-up period, the proficiency-based test on the EyeSi simulator was strongly correlated to real-life performance measured by motion-tracking software of cataract surgical videos with a Pearson correlation coefficient of -0.70(p=0.017). Conclusion: Performance on the EyeSi simulator is significantly and highly correlated to real-life surgical performance. However, it is recommended that performance assessments are made using multiple data sources

We have demonstrated the first in-vivo high resolution images of normal punctal and vertical canalicular anatomy using spectral OCT. There is currently no other practical way to accurately image punctal and proximal canalicular morphology in vivo. OCT is a convenient and readily available tool in most eye clinics with resolution ideally suited for imaging of the punctum and proximal canaliculus.