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Computer analysis of individual cataract surgery segments in the operating room

Balal, S; Smith, P; Bader, T; Tang, HL; Sullivan, P; Thomsen, ASS; Carlson, T; (2019) Computer analysis of individual cataract surgery segments in the operating room. Eye , 33 pp. 313-319. 10.1038/s41433-018-0185-1. Green open access

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Abstract

Purpose: Objective feedback is important for the continuous development of surgical skills. Motion tracking, which has previously been validated across an entire cataract procedure, can be a useful adjunct. We aimed to measure quantitative differences between junior and senior surgeons’ performance in three distinct segments. We further explored whether automated analysis of trainee surgical videos through PhacoTracking could be aligned with metrics from the EyeSi virtual reality simulator, allowing focused improvement of these areas in a controlled environment. / Methods: Prospective cohort analysis, comparing junior vs. senior surgeons’ real-life performance in distinct segments of cataract surgery: continuous curvilinear capsulorhexis (CCC), phacoemulsification, and irrigation and aspiration (I&A). EyeSi metrics that could be aligned with motion tracking parameters were identified. Motion tracking parameters (instrument path length, number of movements and total time) were measured. t-test used between the two cohorts for each component to check for any significance (p < 0.05). / Results: A total of 120 segments from videos of 20 junior and 20 senior surgeons were analysed. Significant differences between junior and senior surgeons were found during CCC (path length p = 0.0004; number of movements p < 0.0001; time taken p < 0.0001), phacoemulsification (path length p < 0.0001; number of movements p < 0.0001; time taken p < 0.0001), and irrigation and aspiration (path length p = 0.006; number of movements p = 0.013; time taken p = 0.036). / Conclusion: Individual segments of cataract surgery analysed using motion tracking appear to discriminate between junior and senior surgeons. Alignment of motion tracking and EyeSi parameters could enable independent, task specific, objective and quantitative feedback for each segment of surgery thus mirroring the widely utilised modular training.

Type: Article
Title: Computer analysis of individual cataract surgery segments in the operating room
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/s41433-018-0185-1
Publisher version: https://doi.org/10.1038/s41433-018-0185-1
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10049543
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