ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Objective structured assessment of posterior capsular rupture management.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
purposePosterior capsular rupture (PCR) management requires specific technical skills. Simulation-based training may support skill acquisition but requires validated, procedure-specific assessment tools. This study aimed to develop and validate a structured scale for assessing technical performance during PCR management.
methodsThe Objective Structured Assessment of Posterior Capsular Rupture (OSA-PCR) was developed using a Delphi consensus process involving 20 cataract surgeons. Validation was subsequently conducted in a prospective simulation-based study including 12 residents and surgeons, who performed two standardized PCR scenarios on a virtual-reality simulator, separated by structured instructor-guided training. The 24 recorded performances were independently evaluated by four experts. Psychometric evaluation of the OSA-PCR included reliability, internal consistency, construct validity, and responsiveness, with correlation to simulator scores.
resultsThe final OSA-PCR comprised 19 items, all achieving 100% consensus in the third Delphi round. Interrater reliability was excellent (ICC[2,1] = 0.95; 95% CI, 0.89-0.98; ICC[2,4] = 0.90; 95% CI, 0.77-0.96), as was intrarater reliability (ICC[3,1] = 0.98). Internal consistency was high (Cronbach α = 0.93; McDonald ω = 0.94). OSA-PCR scores showed strong correlation with EyeSi Surgical scores (r = 0.90; 95% CI, 0.77-0.96) while providing greater discrimination among lower-performing cases. Scores improved significantly after training (median 63.5 vs. 96.6; P = 0.0005) but did not differ significantly across experience levels (P = 0.71).
conclusionThe OSA-PCR is a valid, reliable, and responsive instrument for assessing technical performance during simulated PCR management. It enables structured, procedure-specific evaluation and may support competency-based training and assessment in cataract surgery education.
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