Impact Of Virtual Reality Simulator-Based Training In Reducing Complications In Cataract Surgery : A Comparative Analysis

To evaluate the impact of virtual reality simulator (VRS)-based training in reducing intraoperative complications and re-surgery rates among resident surgeons performing Manual Small Incision Cataract Surgery (MSICS).

 Charitable section of the tertiary hospital through direct availed services at free /subsidised cost.

Design:  Interventional study

 A retrospective cohort study was conducted, analyzing complication rates before and after a week-long VRS-based microsurgical retraining program. Residents with the highest complication rates were enrolled, receiving structured theoretical sessions and hands-on simulator training focusing on key surgical steps such as scleral tunnel construction, capsulorhexis, and intraocular lens (IOL) placement. Post-training surgical performance was assessed using electronic medical records.

 Eight residents participated in the retraining program. Prior to VRS training, 2372 surgeries were performed with a complication rate of 3.6%. After retraining, 2246 surgeries were analyzed, showing a significant reduction in complications to 1.2% (p < 0.01). The number of re-surgeries also reduced from 0.8% to 0.13%. Significant decrease in serious complications, including zonular dialysis with vitreous disturbances and posterior capsular rent. Additionally, all surgeons successfully implanted an IOL in their post-training surgeries.

 VRS-based retraining effectively improves surgical proficiency, reducing complication and re-surgery rates in MSICS. This study highlights the importance of incorporating simulation-based training into ophthalmology residency programs, particularly in high-volume surgical settings.