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Session Title: Ocular pathologies and training and innovation
Session Date/Time: Monday 07/10/2013 | 08:00-10:00
Paper Time: 08:06
Venue: Emerald (First Floor)
First Author: : T.Bader UK
Co Author(s): : G. Saleh P. Smith L. Tang K. Young Y. Athanasiadis P.
Computer vision analysis has been validated as a tool to evaluate surgical skill. In this study we investigated a novel interactive video based tool for the evaluation of performance during actual cataract surgery. The evaluation of a surgeon"s skill is an essential part of training and in recent years, attempts have been made to make surgical assessment more objective. We developed this video based tool to numerically assess surgical performance by analysing movement parameters. This technology has the potential to be developed for use in clinical practice, to provide salient objective feedback to surgical trainees.
Moorfields Eye Hospital, London
A prospective cohort analysis was undertaken using videos of complete cataract operations. Ten videos of junior surgeons (<200 cases experience) and ten videos of senior surgeons (>1000 cases experience) were analysed. Movement parameters were analysed for a complete cataract operation and for individual segments of the procedure. Movements measured included time, path length, number of movements of the instruments used plus other higher order mathematical parameters, which analysed movement in 3 dimensional space. Individually analysed segments included the incision, continuous curvilinear capsulorhexis, phacoemulsification, irrigation and aspiration, lens insertion.
The results showed significant statistical differences between junior and senior surgeons in terms of performance. Junior surgeons used a greater total path length to complete a procedure and as a group, had a larger variation in the total path length. The senior group was more consistent. A similar pattern was observed with number of movements. Significant statistical differences were found between junior and senior surgeons for total path length (P=.002), number of movements (P=.05), and total time (P=.004) for a complete cataract operation. Videos of the procedures with a more detailed analysis of the individual segments of cataract surgery will be shown during the presentation.
Our study has shown that motion analysis can be successfully applied to video recordings of cataract surgery to provide robust measurements of instrument motion. Complete procedures as well as individual segments of cataract surgery can be evaluated, with motion metrics being found for each task that are indicative of surgical skill. This technology can therefore discriminate between different levels of competency and has the potential to improve objective quantitative feedback in surgical training. Individual numerical reports could be generated to supplement human feedback, with the aim of improving overall performance. This sort of interactive feedback is not currently available with existing training techniques and therefore further research is required to assess the educational application of this technology. Financial Disclosure: There are no financial interests to disclose.
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