Evaluating continuous curvilinear capsulorhexis proficiency via video analysis.

Area of Science:

• Ophthalmology
• Surgical Technology
• Medical Device Development

Background:

• Continuous curvilinear capsulorhexis (CCC) quality is crucial for successful cataract surgery, impacting posterior capsule opacification and visual outcomes.
• Objective assessment of CCC manipulation is needed to standardize surgical training and evaluate proficiency.

Purpose of the Study:

• To develop and validate a novel metric, the Capsulotomy Proficiency Index (CPI), for objectively evaluating continuous curvilinear capsulorhexis (CCC) quality.
• To assess the correlation between CPI scores and surgeon experience levels.

Main Methods:

• A MATLAB-based custom code was developed to analyze surgical videos, extracting parameters like forceps motion trail, surgical field motion, CCC circularity, deviation, decentration, number of grasps, and operating time.
• An integrated CPI value was calculated by assigning weights to each parameter to provide a comprehensive assessment of CCC manipulation.
• A Mann-Whitney U test was employed to compare mean CPI values between surgeons with different experience levels.

Main Results:

• The study included two groups of surgeons: Group A (less than 500 cataract surgeries) and Group B (more than 1000 cataract surgeries).
• Fifteen CCC surgical videos from each surgeon were analyzed, yielding mean CPI values of 0.47±0.32 for Group A and 0.89±0.23 for Group B.
• A statistically significant difference (p<0.05) in mean CPI was observed between the two groups, with Group B demonstrating higher proficiency.

Conclusions:

• The Capsulotomy Proficiency Index (CPI) effectively quantifies and differentiates surgical skill levels in continuous curvilinear capsulorhexis (CCC) manipulation.
• Objective evaluation using CPI can serve as a valuable tool for surgical training, performance assessment, and quality improvement in cataract surgery.