Ophthalmic Telesurgery with a Low-Cost Smartphone Video System for Surgeon Self-Reflection and Remote Synchronous...

Area of Science:

• Ophthalmology
• Medical Education
• Surgical Training

Background:

• Cataracts cause over a third of global blindness, despite cataract surgery being highly cost-effective.
• Poor surgical outcomes highlight challenges in surgical training quality, especially in low-resource settings.
• Current video recording systems are costly and lack portability, hindering their use in underserved areas.

Purpose of the Study:

• To evaluate smartphone-captured surgical videos for surgeon self-learning and telesurgical consultation.
• To assess the utility and acceptance of smartphone videos in surgical training facilities in Nepal.

Main Methods:

• Quantitative and qualitative methodology used in two Nepalese training facilities.
• Twenty surgeries recorded on smartphones for self-review and performance assessment against ICO-OSCAR SICS Rubric.
• Fifteen surgeries streamed live via Skype for remote consultation with a South African trainer.

Main Results:

• High video quality (65%) and moderate quality (35%) for self-review recordings.
• Very high video quality (92.9%) for live-streamed surgeries.
• Video quality was sufficient for performance assessment using the ICO-OSCAR rubric in all cases.

Conclusions:

• Smartphone-captured surgical videos are of high quality and accepted for reflective teaching.
• The portability and telesurgical capabilities of smartphones support training in diverse settings.
• Further long-term studies are needed to confirm their role in cataract surgery training.