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George M. Saleh, MRCS(Ed), MRCOphth; Yiorgos Voyazis, MBBS; Julian Hance, MD, MRCS; Joel Ratnasothy, MRCS; Ara Darzi, MD, FRCS

Arch Ophthalmol. 2006;124:1263-1266.

Objective  To evaluate motion tracking as an aid to a more objective assessment of ophthalmic microsurgical skill.

Methods  In a cohort study, 3 groups of differing levels of surgical experience were assessed. The groups included novice surgeons (n = 10) with fewer than 5 previously performed corneal sutures, trainee surgeons (n = 10) with 5 to 100 previously performed corneal sutures, and expert surgeons (n = 10) with more than 100 previously performed corneal sutures. The Imperial College Surgical Assessment Device was used for the objective assessment of surgical dexterity during corneal suturing. Each of the subjects used a 10-0 nylon suture in a 3-1-1 pattern on an artificial eye (Royal College of Ophthalmologists, London, England). The Imperial College Surgical Assessment Device measures 3-dimensional spatial vectors via electromagnetic sensors attached to the surgeon's fingers. The number of movements, path length for the respective movements, and time taken to complete the given task were recorded.

Results  Highly statistically significant differences were found between the 3 grades of surgeon experience for time taken (P<.001), number of hand movements (P<.001), and path length of the hand movements (P = .002) to complete the given task.

Conclusions  Motion analysis measured by this technology may be useful in the formal surgical training of residents and as an objective quantitative measure of dexterity.

Author Affiliations: Department of Ophthalmology, Royal Surrey County Hospital, Surrey (Drs Saleh and Voyazis), and Department of Surgical Oncology and Technology, Imperial College, London (Drs Hance, Ratnasothy, and Darzi), England.

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