Alexander Sarossy1, Callum Gin2, Jorge Reyna3, Santosh Khanal4, Rahul Chakrabarti5

Purpose: The Eyesi (Haag-Streit GmbH, Mannheim, Germany®) cataract surgery simulator has been implemented globally to train ophthalmic registrars. Consisting of a Cataract Challenge Course, the program is a virtual reality simulation of cataract surgery. In this study we aimed to determine if there is any correlation between the parameters measured on the Eyesi virtual reality cataract surgery simulator and if these parameters can inform the mindset to microsurgical skill acquisition and development amongst ophthalmology trainees.
Methods: The performance of 56 trainees at the Royal Victorian Eye and Ear Hospital was analysed for five years from 2018 to 2022. The trainees experience ranged from 1st to 4th year. Analysed parameters included Initial Task Performance, Time-to-Gate (the time to reach a threshold score) and Peak Performance. Relationships between the parameters were analysed with Pearson R and significance of difference between correlations was analysed with the psych package in R.
Results: The strongest correlation was found between initial and peak performance (r = 0.810) which was significantly greater than the correlation between Initial Task Performance and Time-to-Gate (r = 0.553, p = 0.03). Time-to-Gate was only weakly correlated with Peak Performance (r = 0.475). The average Total Training Time was 1123 minutes, ranging from 252 to 2039, and the mean peak Cataract Challenge Course score was 442, ranging from 166 to 496.
Conclusion: Our data indicated that Time-to-Gate, Initial Task Performance and Peak Performance are interlinked, indicating those with the highest level of initial performance remain ahead in ability and acquire surgical skills in a simulated microsurgical environment most rapidly.