Virtual Reality Simulation And 3D-Printed Surgical Models Improve The Knowledge And Confidence To Perform Anterior Vitrectomy Of Trainees And Consultants Within Their First Two Years Of Practice.

 To evaluate whether mentor-guided training with a Virtual Reality (VR) simulator and 3D printing artificial eyes improves knowledge and confidence in trainees and early-stage consultants via validated surgical evaluations tools.

• Two separate groups of ophthalmologists were assessed, with 30 ophthalmic surgeons in each group:
• Consultant ophthalmologist surgeons within their first 2 years of practice. 
• Ophthalmology residents currently enrolled in an ophthalmology training program.

Groups were evaluated using a questionnaire before and after the simulation training. Pre-simulation evaluation that included a set of 15 questions about anterior vitrectomy knowledge and confidence. Post-simulation evaluation that included a set of 15 questions about anterior vitrectomy knowledge and confidence following the simulation training. Each evaluation was graded using a questionnaire designed by a group of experts and NOTSS, or using a 1-5 scale grading the following topics: Knowledge of Anterior Vitrectomy principles Level of Confidence Evaluation of Non technical Skills done with the NOTSS questionnaire. 

Expert mentor-surgeons guided study participants through both methods of simulated learning.

• Surgeons hailed from: Mexico, United States, Argentina, Ecuador, Honduras, El Salvador, Barbados, Perú, Colombia, Brazil and Uruguay and had an average age of 35 years old (SD 2.1)  The sex distribution was 48% male and 52% female surgeons.

• Group 2 (ophthalmology residents) saw a statistically significant improvement (p<0.05) in mean ICO-OSCAR and NOTSS score.

• Group 1 (early-stage ophthalmic consultants) also showed a statistically significant improvement (p<0.05) in pre and post questionnaires done by our group of experts and in the NOTSS score. 

• Simulated anterior vitrectomy training using high fidelity VR coupled with simulated cataract surgery on artificial eyes using common phacoemulsification equipment can significantly improve the knowledge and confidence of ophthalmology residents and early-stage ophthalmic consultants if done with the correct methodology and expert surgeons who are trained as surgical mentors.