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“PhacoTracking” An Evolving Paradigm in Ophthalmic Surgical Training

Phillip Smith, BSci; Lilian Tang, BEng, MEng, PhD (Cantab); Vassilis Balntas, MSc, MEng; Karen Young, PhD, CStat; Yannis Athanasiadis, MD, MRCSEd; Paul Sullivan, FRCS, FRCOphth; Badrul Hussain, FRCSEd, MRCOphth; George M. Saleh, FRCSEd, FRCOphth
JAMA Ophthalmol. 2013;131(5):659-661. doi:10.1001/jamaophthalmol.2013.28.
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Motion analysis has been validated as a tool to evaluate surgical skill. We investigated a novel computer vision–based tool for the evaluation of surgical movements during cataract surgery. A prospective cohort analysis of 2 groups was performed. Ten videos of junior surgeons (ie, those with <200 cases) and 10 videos of senior surgeons (ie, those with >1000 cases) were analyzed. Movement parameters were measured over an entire procedure. Significant statistical differences were found between novice and expert surgeons for total path length (P = .002), number of movements (P = .05), and total time (P = .004). Our study has shown that computer vision–based motion analysis can be successfully applied to video recordings of cataract surgery to provide robust measurements of instrument motion. Further work needs to be done to evaluate its usefulness in training and feedback.

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Figure 1. Output from instrument tracking system. The top portion of the output shows the input video and the result of computer vision tracking. The lower portion shows the metrics that are measured by the system.

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Figure 2. Box and whisker plot showing the total path length for novice and expert surgeons. The horizontal line within each box is the median value, and the top and bottom borders of the box are ±1 SD with limit lines showing 95% CIs (±2 SDs).

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Figure 3. Box and whisker plot showing the total number of movements for novice and expert surgeons. The horizontal line within each box is the median value, and the top and bottom borders of the box are ±1 SD with limit lines showing 95% CIs (±2 SDs). The plus signs beyond the whiskers are outliers.

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Figure 4. Box and whisker plot showing the total time taken by novice and expert surgeons. The horizontal line within each box is the median value, and the top and bottom borders of the box are ±1 SD with limit lines showing 95% CIs (±2 SDs).

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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