Impact of Timing During Simulated Vitreoretinal Surgery by Trainees.

Purpose: This study aimed to examine the impact of surgical timing on the performance of vitreoretinal (VR) trainees in a simulated setting.

Methods: In a prospective cross-over observational study, VR trainees were asked to perform various surgical tasks on the Eyesi surgical simulator. These included navigation and anti-tremor, pars plana vitrectomy and posterior vitreous detachment, bimanual training, bimanual scissors use, and epiretinal membrane peeling. The trainees were randomly assigned to Group A (performed tasks during morning hours) and Group B (performed tasks during evening hours). After completing assigned tasks, the trainees were asked to cross over to the other group. Primary outcome measures were objective scores and time to perform each surgical maneuver in both groups. Secondary outcome measures included subjective scores given by each trainee and complications encountered.

Results: Eight VR trainees, three males (37.5%) and five females (62.5%), were included in the study. The mean objective score obtained after performing various surgical tasks was similar in both groups. The time taken to complete the above tasks was identical. Though the complications were more in the evening than in the morning, the difference was not statistically significant. Subjectively, residents did not find any difference in either group.

Conclusions: The timing of VR surgery does not alter the surgical performance in a simulator setting. While objective measures showed no significant difference, complications trended higher in the evening.