Educational Concerns About the Safety of Cataract Surgery During Residency: The E3CAPS Pedagogic Study

IntroductionCataract surgery is the most common surgical procedure performed in France. While the incidence of intraoperative complications affecting visual prognosis is extremely low, given the large number of patients operated on, the absolute number of patients affected by complications is quite high. Complication rates are significantly higher when ophthalmology residents (ORs) perform the surgery. Although lack of experience remains the main risk factor, sleep deprivation may adversely affect ORs' successful surgery rate. The value of the EyeSi & REG; surgical simulator in initial training has been demonstrated to increase cataract surgery safety through the transfer of surgical skills from the simulator to the operating room. However, there is no consensus regarding how much training is needed before the first-time ORs are allowed to operate. There is also no scientific evidence that sleep deprivation is associated with a decrease in surgical performance. Establishing a validated protocol for cataract surgery training using the EyeSi surgical simulator (referred to further as the EyeSi) and identifying risk factors for intraoperative complications related to sleep deprivation will improve cataract surgery safety and lead to the reorganization of our healthcare systems.Methods and Planned OutcomesThis multi-centre educational cohort study will include two distinct axes which will both aim to reduce the risks of cataract surgery. Enrollment will include 16 first-year ORs for Axis 1 and 25 experienced residents for Axis 2, all from the University Hospitals of Nantes, Tours, Angers and Rennes. Axis 1 will focus on investigating the learning curve of first-year ORs using the EyeSi, following the training program recommended by the College des Ophtalmologistes Universitaires de France in order to set up a future licence to operate. Axis 2 will evaluate the impact of sleep deprivation on the surgical performance of experienced ORs using the EyeSi.

Automated summary

Cataract surgery is common in France, but complications can occur due to lack of experience and sleep deprivation. The use of the EyeSi surgical simulator for training has shown potential, but there is no consensus on the necessary training for first-time surgeons. This multi-center cohort study aims to establish a validated training protocol using the EyeSi and evaluate the impact of sleep deprivation on surgical performance.