Confidence in managing open-globe injuries and endophthalmitis: a pre- and postwet-lab training evaluation

The purpose of this study was to evaluate the effect of 2 days of wet-lab training on confidence in the management of open-globe injury (OGI) and endophthalmitis.

In a porcine wet lab, 24 participants were trained on 12 surgical tasks, including pars plana vitreous sampling and corneal and scleral suturing. Participants anonymously rated their confidence in managing OGI and endophthalmitis on a scale from 1 to 10 before the course, immediately after its completion, and 6 months later.

Confidence in corneal suturing improved from a median of 1 (interquartile range [IQR] = 1) to 7 (IQR = 3) immediately after the course (p < 0.001), and to 3 (IQR = 2) six months later (p = 0.001). For scleral suturing, confidence improved from a median of 1 (IQR = 1) to 7 (IQR = 2) (p < 0.001), and to 3 (IQR = 3) 6 months later (p = 0.001). Confidence in endophthalmitis treatment improved from a median of 5 (IQR = 5) to 8 (IQR = 4) immediately after the course (p < 0.001), and remained at 8 (IQR = 2) 6 months later (p = 0.012).

Wet-lab training effectively increased participants' confidence in managing OGI. Key elements of the ophthalmic surgeon's learning curve can be addressed in a porcine wet lab, thereby reducing the risk of poor patient outcomes. Six months later, the positive effect on confidence remained significant, despite the expected decline over time. Nonetheless, there remains scope for further improvement in these essential surgical skills.