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Objective skill assessment for cataract surgery from surgical microscope video.

Rebecca Hisey1, Henry Lee2, Adrienne Duimering3

  • 1School of Computing, Queen's University, Kingston, ON, Canada. rebecca.hisey@queensu.ca.

International Journal of Computer Assisted Radiology and Surgery
|April 24, 2025
PubMed
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Object detection from surgical videos effectively assesses cataract surgery skills, matching or exceeding traditional six-degree-of-freedom (6-DOF) tracking. This approach offers a cost-effective, hardware-free alternative for automated surgical skill evaluation.

Area of Science:

  • Ophthalmology
  • Surgical Education
  • Computer Vision

Background:

  • Automated surgical skill evaluation is crucial for training.
  • Traditional six-degree-of-freedom (6-DOF) tracking systems are expensive and difficult to implement clinically.
  • Object detection offers a potentially more accessible method using standard video.

Purpose of the Study:

  • To determine if object detection from monocular surgical microscope video can effectively assess trainee skill in cataract surgery.
  • To compare the efficacy of object detection with 6-DOF tracking for skill assessment.

Main Methods:

  • 25 cataract surgery simulations were recorded using surgical microscope video and 6-DOF tracking.
  • Expert ophthalmologists graded videos using the ICO-OSCAR:SICS rubric.
Keywords:
Cataract surgeryObject detectionVideo-based skill assessment

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  • Motion-based metrics were derived from both object detection and 6-DOF tracking.
  • Ordinal regression models predicted scores, and correlations with expert scores were compared.

    • Main Results:

    • Object detection metrics generally showed stronger correlations with expert scores than 6-DOF tracking.
    • Scores predicted from object detection had significantly stronger correlations for four scoring criteria.
    • 6-DOF tracking offered no significant advantage in score prediction.

    Conclusions:

    • Skill assessment using object detection from monocular video can match or surpass 6-DOF tracking.
    • This validates the feasibility of using object detection for surgical skill assessment without requiring additional hardware.
    • Object detection presents a practical and accessible tool for automated surgical skill evaluation.