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Phacoemulsification Skills Training and Assessment
  1. Anthony Spiteri1,
  2. Rajesh Aggarwal2,
  3. Tom Kersey3,
  4. Larry Benjamin4,
  5. Ara Darzi2 and
  6. Philip Bloom5
  1. 1 South West Thames rotation, United Kingdom;
  2. 2 St Mary's Hospital, Imperial College, United Kingdom;
  3. 3 South West Pensinsula rotation, United Kingdom;
  4. 4 Stoke Mandeville Hospital NHS Trust, United Kingdom;
  5. 5 Western Eye Hospital, United Kingdom
  1. * Corresponding author; email: antspit{at}


Background: The quality of ophthalmic surgical training is increasingly challenged by an untimely convergence of several factors. This article reviews the tools currently available for training and assessment in phacoemulsification surgery.

Methods: Medline searches were performed to identify articles with combinations of the following words: phacoemulsification, training, curriculum, virtual reality and assessment. Further articles were obtained by manually searching the reference lists of identified papers.

Results: Thus far phacoemulsification training outside the operating room (OR) included wetlabs and micro-surgical skills courses. These methods have been criticized for being unrealistic, inaccurate and inconsistent. Virtual reality (VR) simulators have the ability to teach phacoemulsification psychomotor skills as well as to carry out objective assessment.

Other ophthalmic surgical skill assessment tools such as Objective Assessment of Skills in Intraocular Surgery (OASIS) and Global Rating Assessment of Skills in Intraocular Surgery (GRASIS) are emerging. Assessor bias is minimised by using video-based assessments which have been shown to reduce subjectivity. Dexterity analysis technology such as the Imperial College Surgical Assessment Device (ICSAD) and virtual reality simulators can be used as objective assessment devices.

Conclusion: Improvements in technology can be utilized in ophthalmology and will help address the increasingly limited opportunities for training and assessment during training and throughout one’s career (re-training and re-validation). This will inevitably translate into enhanced patient care.

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