Can virtual reality surgical simulator improve the function of the non-dominant hand in ophthalmic surgeons?

Purpose: Phacoemulsification surgery requires the use of both hands; however, some surgeons may not be comfortable using their non-dominant hand, especially in critical steps such as chopping. This work aims at assessing whether a virtual reality simulator can help cataract surgeons train their non-dominant hand using the capsulorhexis module. Methods: This was a prospective observational study including thirty ophthalmic surgeons; none of them had previous training on the EyeSi surgical simulator. Twenty-three were experienced, and seven were intermediate surgeons. Surgeons were asked to perform capsulorhexis three times using their dominant hand and then using their non-dominant hand. A performance score based on efficiency, target achievement, instrument handling, and tissue treatment was calculated by the simulator. Results: A significant improvement in the score of surgeons using their non-dominant hand from the first trial (69.57 ± 18.9) to the third trial (84.9 ± 9.2) (P < 0.001) was found, whereas such improvement was not noted with the dominant hand (P = 0.12). Twenty-six surgeons managed to reach 90% of the mean score achieved by dominant hand by using their non-dominant hand, 11 (36.7%) from the first trial, seven (23.3%) from the second, and eight (26.7%) from the third. Conclusion: Cataract surgeons showed significant improvement in the scores of their non-dominant hands with simulator training. Thus, it is possible to safely train non-dominant hands for difficult tasks away from the operating room, which would be a fruitful addition to residency training programs.