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Construct validity of five phacoemulsification modules on the EyeSi surgical simulator: a cross-sectional study across three levels of surgical expertise.

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Τίτλος: Construct validity of five phacoemulsification modules on the EyeSi surgical simulator: a cross-sectional study across three levels of surgical expertise.
Συγγραφείς: Laamoud I; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco. ismail.laamoud@usmba.ac.ma., Moutei H; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco., Chraibi F; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco., Abdellaoui M; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco., Benatiya Andaloussi I; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Πηγή: International ophthalmology [Int Ophthalmol] 2026 Sep 11; Vol. 46 (1). Date of Electronic Publication: 2026 Sep 11.
Τύπος έκδοσης: Journal Article; Comparative Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Kluwer Country of Publication: Netherlands NLM ID: 7904294 Publication Model: Electronic Cited Medium: Internet ISSN: 1573-2630 (Electronic) Linking ISSN: 01655701 NLM ISO Abbreviation: Int Ophthalmol Subsets: MEDLINE
Imprint Name(s): Publication: Dordrecht : Kluwer
Original Publication: The Hague, Junk.
Ιατρικοί όροι (MeSH): Phacoemulsification*/education , Simulation Training*/methods , Internship and Residency*/methods , Education, Medical, Graduate*/methods , Ophthalmology*/education , Clinical Competence* , Computer Simulation* , Virtual Reality*, Humans ; Cross-Sectional Studies ; Female ; Male ; Reproducibility of Results ; Adult
Περίληψη: Purpose: Virtual reality simulators are increasingly integrated into cataract surgery training to facilitate skill acquisition outside the operating room. However, their educational value depends on the validity of simulated tasks. This study aimed to evaluate the construct validity of five procedural phacoemulsification modules on the EyeSi simulator (version 3.10.67) across three levels of surgical expertise.
Methods: This cross-sectional comparative study was conducted at a tertiary referral hospital and a university simulation center in Morocco. Twenty-five participants were stratified into novices (n = 17), advanced residents (n = 4), and expert surgeons (n = 4). Participants completed five EyeSi phacoemulsification modules, and performance metrics were compared across groups.
Results: Overall simulator performance improved with increasing surgical experience. Total scores differed significantly between groups (p = 0.005), with median values of 311, 365, and 473 for novices, advanced residents, and experts, respectively. Total completion time also differed significantly (p = 0.047). At the module level, construct validity was demonstrated for capsulorhexis (p = 0.030), divide and conquer (p = 0.009), and intraocular lens (IOL) insertion (p = 0.002), whereas hydrodissection and irrigation/aspiration did not reach statistical significance (p = 0.084 and p = 0.053, respectively).
Conclusions: In a recent EyeSi software version, construct validity was confirmed for three of the five evaluated procedural modules across three levels of surgical expertise. Complementary analyses further supported an association between simulator performance and surgical experience across all modules. These findings reinforce the educational value of the EyeSi simulator while highlighting the need for the continuous evaluation and refinement of individual procedural modules and their scoring algorithms.
(© 2026. The Author(s), under exclusive licence to Springer Nature B.V.)
Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests. Declaration of generative AI and AI-assisted technologies: During the preparation of this work, the authors used ChatGPT to assist with improving the clarity and fluency of the English language. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.
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Siow WT, Tan G, Loo C, Khoo K, Kee A, Tee A et al (2021) Impact of structured curriculum with simulation on bronchoscopy. Respirology 26(6):597–603. https://doi.org/10.1111/resp.14054. (PMID: 10.1111/resp.1405433876525)
Kaplowitz K, Yazdanie M, Abazari A (2018) A review of teaching methods and outcomes of resident phacoemulsification. Surv Ophthalmol 63(2):257–267. https://doi.org/10.1016/j.survophthal.2017.09.006. (PMID: 10.1016/j.survophthal.2017.09.00628941765)
Ng EMC, Salowi MA, Othman O, Uthman R, Ngah NF (2025) Cumulative summation (CUSUM)—as a tool for objective analysis of learning curve for surgeons in acquiring competency in phacoemulsification. BMC Ophthalmol 25(1):475. https://doi.org/10.1186/s12886-025-04246-x. (PMID: 10.1186/s12886-025-04246-x4083085112362908)
Khodriss C, Bouri HE, Benmerak R, Tahiri R, Bendali J, Benhaddouch Y et al (2025) Second victim syndrome in ophthalmology: contributory factors and insights from the first study. AJO Int 2(3):100150. https://doi.org/10.1016/j.ajoint.2025.100150. (PMID: 10.1016/j.ajoint.2025.100150)
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Contributed Indexing: Keywords: Cataract surgery; Construct validity; EyeSi surgical simulator; Phacoemulsification; Surgical simulation; Virtual reality
Entry Date(s): Date Created: 20260911 Date Completed: 20260911 Latest Revision: 20260911
Update Code: 20260912
DOI: 10.1007/s10792-026-04251-z
PMID: 42726347
Βάση Δεδομένων: MEDLINE
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  Label: Title
  Group: Ti
  Data: Construct validity of five phacoemulsification modules on the EyeSi surgical simulator: a cross-sectional study across three levels of surgical expertise.
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  Data: <searchLink fieldCode="AU" term="%22Laamoud+I%22">Laamoud I</searchLink>; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco. ismail.laamoud@usmba.ac.ma.<br /><searchLink fieldCode="AU" term="%22Moutei+H%22">Moutei H</searchLink>; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.<br /><searchLink fieldCode="AU" term="%22Chraibi+F%22">Chraibi F</searchLink>; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.<br /><searchLink fieldCode="AU" term="%22Abdellaoui+M%22">Abdellaoui M</searchLink>; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.<br /><searchLink fieldCode="AU" term="%22Benatiya+Andaloussi+I%22">Benatiya Andaloussi I</searchLink>; Ophthalmology Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
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  Data: <searchLink fieldCode="JN" term="%227904294%22">International ophthalmology</searchLink> [Int Ophthalmol] 2026 Sep 11; Vol. 46 (1). <i>Date of Electronic Publication: </i>2026 Sep 11.
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  Data: Journal Article; Comparative Study
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  Data: English
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Kluwer%22">Kluwer </searchLink><i>Country of Publication: </i>Netherlands <i>NLM ID: </i>7904294 <i>Publication Model: </i>Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1573-2630 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2201655701%22">01655701 </searchLink><i>NLM ISO Abbreviation: </i>Int Ophthalmol <i>Subsets: </i>MEDLINE
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  Data: <i>Publication</i>: Dordrecht : Kluwer<br /><i>Original Publication</i>: The Hague, Junk.
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  Data: <searchLink fieldCode="MM" term="%22Phacoemulsification%22">Phacoemulsification*</searchLink>/<searchLink fieldCode="MM" term="%22Phacoemulsification+education%22">education</searchLink> <br /><searchLink fieldCode="MM" term="%22Simulation+Training%22">Simulation Training*</searchLink>/<searchLink fieldCode="MM" term="%22Simulation+Training+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Internship+and+Residency%22">Internship and Residency*</searchLink>/<searchLink fieldCode="MM" term="%22Internship+and+Residency+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Education%2C+Medical%2C+Graduate%22">Education, Medical, Graduate*</searchLink>/<searchLink fieldCode="MM" term="%22Education%2C+Medical%2C+Graduate+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Ophthalmology%22">Ophthalmology*</searchLink>/<searchLink fieldCode="MM" term="%22Ophthalmology+education%22">education</searchLink> <br /><searchLink fieldCode="MM" term="%22Clinical+Competence%22">Clinical Competence*</searchLink> <br /><searchLink fieldCode="MM" term="%22Computer+Simulation%22">Computer Simulation*</searchLink> <br /><searchLink fieldCode="MM" term="%22Virtual+Reality%22">Virtual Reality*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Cross-Sectional+Studies%22">Cross-Sectional Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Reproducibility+of+Results%22">Reproducibility of Results</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: Virtual reality simulators are increasingly integrated into cataract surgery training to facilitate skill acquisition outside the operating room. However, their educational value depends on the validity of simulated tasks. This study aimed to evaluate the construct validity of five procedural phacoemulsification modules on the EyeSi simulator (version 3.10.67) across three levels of surgical expertise.<br />Methods: This cross-sectional comparative study was conducted at a tertiary referral hospital and a university simulation center in Morocco. Twenty-five participants were stratified into novices (n = 17), advanced residents (n = 4), and expert surgeons (n = 4). Participants completed five EyeSi phacoemulsification modules, and performance metrics were compared across groups.<br />Results: Overall simulator performance improved with increasing surgical experience. Total scores differed significantly between groups (p = 0.005), with median values of 311, 365, and 473 for novices, advanced residents, and experts, respectively. Total completion time also differed significantly (p = 0.047). At the module level, construct validity was demonstrated for capsulorhexis (p = 0.030), divide and conquer (p = 0.009), and intraocular lens (IOL) insertion (p = 0.002), whereas hydrodissection and irrigation/aspiration did not reach statistical significance (p = 0.084 and p = 0.053, respectively).<br />Conclusions: In a recent EyeSi software version, construct validity was confirmed for three of the five evaluated procedural modules across three levels of surgical expertise. Complementary analyses further supported an association between simulator performance and surgical experience across all modules. These findings reinforce the educational value of the EyeSi simulator while highlighting the need for the continuous evaluation and refinement of individual procedural modules and their scoring algorithms.<br /> (© 2026. The Author(s), under exclusive licence to Springer Nature B.V.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Declarations. Conflict of interest: The authors declare no competing interests. Declaration of generative AI and AI-assisted technologies: During the preparation of this work, the authors used ChatGPT to assist with improving the clarity and fluency of the English language. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.
– Name: Ref
  Label: References
  Group: RefInfo
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  Data: <i>Keywords: </i>Cataract surgery; Construct validity; EyeSi surgical simulator; Phacoemulsification; Surgical simulation; Virtual reality
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        Text: English
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      – SubjectFull: Phacoemulsification education
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    Titles:
      – TitleFull: Construct validity of five phacoemulsification modules on the EyeSi surgical simulator: a cross-sectional study across three levels of surgical expertise.
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              Text: 2026 Sep 11
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              Y: 2026
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