Goat Eye Wet Lab Training Model: Translating Skills To Human Cataract Surgery - A Cusum And Cost-Effectiveness Analysis

To evaluate the effectiveness of a structured goat eye wet lab training model in accelerating surgical competency during early human cataract surgery using CUSUM learning curve analysis, and to compare its cost-effectiveness with simulator-based training.

A prospective interventional study was conducted at Drishti Netralaya involving 34 ophthalmology trainees undergoing structured Cataract surgery training. 

The training protocol included stepwise modules on fresh goat eyes focusing on making of peritomy, corneo-scleral tunnel, capsulorhexis creation, nucleus prolapse, cortical aspiration. Trainees were assessed using: OSATS-based surgical scoring, posterior capsular rupture (PCR) rates, capsulorhexis and corneo-scleral tunnel completion rates. Learning curves were evaluated using cumulative summation (CUSUM) analysis, defining acceptable failure rate at 5%.Cost analysis included infrastructure, consumables, and per-trainee training expenditure, compared with published costs of virtual reality simulator training. Cost per trainee was calculated and compared with simulator-based models.

Among 34 trainees, 64.7% were fresh surgeons. In the fresh group, OSATS improved from 5 to 26, while moderate trainees improved from 8 to 32. PCR rate during the first 50 human cases was 5% in fresh trainees and 4% in moderate trainees, meeting international safety benchmarks. CUSUM analysis demonstrated competency stabilization at 24 cases in fresh trainees and 15 cases in moderate trainees. Wet lab training cost was approximately ₹250 (USD 3) per trainee per day, substantially lower than simulator-based alternatives.

Structured goat eye wet lab training significantly accelerates surgical competency, reduces early complication rates, and provides a highly cost-effective model for surgical education in resource-limited settings.