Virtual reality cataract surgery simulation

Is Your Eye Surgery Skill Up to Par? How Virtual Reality Scoring Can Help

Rhea Morgan in Health & Wellness December 2025 • 3 min read.

"Discover how human-based video scoring enhances virtual reality cataract surgery assessments, ensuring top-notch surgical skills."

Cataract surgery training is rapidly evolving, with virtual reality (VR) simulators becoming a crucial part of the learning process. These simulators offer a safe and standardized environment for surgeons to hone their skills before operating on real patients. But how do we accurately measure a surgeon's proficiency in a virtual setting?

A recent study from Lund University, Sweden, delves into this very question by comparing the internal computer-based scoring of the Eyesi surgical simulator with human-based video scoring. The goal was to determine which method better distinguishes between experienced cataract surgeons and those still in training.

The study highlights the importance of accurate assessment in surgical training and demonstrates how combining technology with expert human insight can lead to more effective evaluation methods.

Eyesi vs. the Human Eye: Unveiling the Best Scoring Method

Virtual reality cataract surgery simulation

The study involved 7 experienced cataract surgeons and 17 medical students, all of whom performed cataract surgery modules on the Eyesi simulator. These modules included key steps such as capsulorhexis, hydromaneuvers, and phacoemulsification.

The Eyesi simulator automatically calculated a score for each performance, but the researchers also had two experienced cataract surgeons analyze video recordings of the simulations. These experts used the Objective Structured Assessment of Cataract Surgical Skill (OSACSS) and modified Objective Structured Assessment of Surgical Skills (OSATS) tools to evaluate the participants' techniques.

Capsulorhexis: Creating a circular opening in the lens capsule.
Hydromaneuvers: Separating the lens nucleus from the cortex using fluid.
Phacoemulsification: Breaking up and removing the cataract using ultrasound energy.

By comparing the simulator's scores with the expert video evaluations, the researchers could determine which method was more effective at differentiating skill levels.

The Verdict: Human Insight Elevates Surgical Assessment

The study revealed a significant finding: video-based scoring by experts was superior to the Eyesi simulator's internal scoring system, particularly for the phacoemulsification procedure. The simulator's scoring for hydromaneuvers and phacoemulsification was deemed unacceptably poor in its ability to discriminate skill levels.

This suggests that while VR simulators offer valuable training opportunities, their scoring systems may need refinement. Incorporating human-based video analysis can provide a more nuanced and accurate assessment of surgical competence.

As surgical training continues to evolve, combining the benefits of VR simulation with the expertise of experienced surgeons will likely play a key role in producing highly skilled and confident ophthalmologists.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/opth.s48374, Alternate LINK

Title: Ready For Or Or Not? Human Reader Supplements Eyesi Scoring In Cataract Surgical Skills Assessment

Subject: Ophthalmology

Journal: Clinical Ophthalmology

Publisher: Informa UK Limited

Authors: Madeleine Selvander, Peter Asman

Published: 2013-10-01

Everything You Need To Know

What role do virtual reality simulators play in modern cataract surgery training?

Virtual reality simulators like Eyesi offer a standardized and safe environment for cataract surgery training, allowing surgeons to practice essential steps such as capsulorhexis, hydromaneuvers, and phacoemulsification before operating on real patients. This controlled setting is crucial for skill development and reducing risks associated with early surgical experience.

How did the Lund University study evaluate the effectiveness of virtual reality cataract surgery training?

A recent study compared the Eyesi simulator's internal scoring with expert video analysis using tools like OSACSS and modified OSATS. The study found that human-based video scoring by experienced cataract surgeons was more effective at differentiating skill levels, especially during the phacoemulsification procedure, highlighting the limitations of relying solely on automated simulator scoring.

What are OSACSS and modified OSATS, and how are they used in surgical training?

OSACSS (Objective Structured Assessment of Cataract Surgical Skill) and modified OSATS (Objective Structured Assessment of Surgical Skills) are evaluation tools used by experienced cataract surgeons to analyze video recordings of virtual reality cataract surgery simulations. These tools provide a structured way to assess surgical techniques, offering a more nuanced understanding of a surgeon's proficiency compared to automated scoring systems.

What were the key findings regarding the accuracy of virtual reality simulator scoring versus human expert evaluations?

The study revealed that while virtual reality simulators offer valuable training environments, their internal scoring systems, particularly for hydromaneuvers and phacoemulsification, may not accurately reflect a surgeon's skill level. Expert video analysis using OSACSS and modified OSATS proved superior, suggesting that integrating human insight with technology enhances surgical assessment and ensures comprehensive evaluation.

Beyond the specific procedures mentioned (capsulorhexis, hydromaneuvers, and phacoemulsification), what are the broader implications of the study's findings for surgical training and assessment?

Capsulorhexis involves creating a circular opening in the lens capsule, hydromaneuvers separate the lens nucleus from the cortex using fluid, and phacoemulsification breaks up and removes the cataract using ultrasound energy. While the study focused on these specific procedures within cataract surgery, further research is needed to determine if the superiority of human-based video scoring extends to other surgical procedures and specialties. The need for continuous assessment methods is paramount.