Sir,
We read with interest the important study undertaken by Saleh et al.1
However, the only exclusion criterion for selection of candidates was novices with more than 2 h of simulation/intraocular surgical experience. The authors do not mention whether a baseline test of visual acuity and stereopsis was recorded for participants. The importance of stereopsis in achieving satisfactory skills in ophthalmic surgery remains debated.2 Recent studies have demonstrated that a decreased stereoacuity results in a statistically significant decrease in simulated surgical performance for most participants.3, 4 We suggest that all ophthalmic simulator-based studies should measure participant visual acuity and stereoacuity to ensure reliable results.
The authors also discuss the emergence of a ‘learning curve’ achieved in repeated tasks. In our simulator-based studies evaluating parameters affecting surgeon performance, we minimised the learning curve before data collection.5 Using one attempt level 1, one attempt level 2 and six attempts level 4 forceps module, stabilised scores for our participants. Applying the same methodology to other modules might produce similar results and could be used in training.
References
Saleh GM, Theodoraki K, Gillan S, Sullivan P, O'Sullivan F, Hussain B et al. The development of a virtual reality training programme for ophthalmology: repeatability and reproducibility (part of the International Forum for Ophthalmic Simulation Studies). Eye 2013; 27 (11): 1269–1274.
Elliot A . Is stereopsis essential to be a competent ophthalmic surgeon?. Royal College of Ophthalmologists: London, 2008 Available at http://www.rcophth.ac.uk/page.asp?section=172§ionTitle=Information+from+the+Visual+Standards+Sub-Committee.
Selvander M, Åsman P . Stereoacuity and intraocular surgical skill: effect of stereoacuity level on virtual reality intraocular surgical performance. J Cataract Refract Surg 2011; 37 (12): 2188–2193.
Waqar S, Williams O, Park J, Modi N, Kersey T, Sleep T . Can virtual reality simulation help to determine the importance of stereopsis in intraocular surgery? Br J Ophthalmol 2012; 96 (5): 742–746.
Park J, Williams O, Waqar S, Modi N, Kersey T, Sleep T . Safety of non-dominant hand ophthalmic surgery. J Cataract Refract Surg 2012; 38 (12): 2112–2116.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Swampillai, A., Waqar, S., Park, J. et al. The development of a virtual reality training programme for ophthalmology: study must take into account visual acuity and stereopsis. Eye 28, 503 (2014). https://doi.org/10.1038/eye.2014.20
Published:
Issue Date:
DOI: https://doi.org/10.1038/eye.2014.20
This article is cited by
-
Response to Swampillai et al
Eye (2014)