A comparison of hand- and foot-activated surgical tools in simulated ophthalmic surgery

Objective: To compare the performance characteristics of hand-activated surgical tools with those of foot-activated surgical tools using a virtual-reality simulator of intraocular surgery. Design: Prospective, unmasked, interventional cohort study. Participants: Eighteen ophthalmology residents at the University of Toronto. Methods: The EYESi ophthalmic surgery simulator was used for the study. The surgical tool evaluated was a simulation of intraocular forceps activated by either a handpiece or a foot pedal. Each resident completed 2 modules - a dexterity module and a capsulorrhexis/ cataract module. Each module was completed 4 times, alternating between the hand-activated forceps and the foot-activated forceps. An overall score was calculated for each task on the basis of the efficiency and accuracy of completion of the task, with 100 representing a perfect score. Overall scores were compared between hand and foot control for both modules. Results: For the dexterity module, there was no significant difference in the overall scores between the 2 groups (91 ± 6 and 93 ± 6 for the foot- and hand-activated forceps groups, respectively; p > 0.05, t test). For the capsulorrhexis module, overall scores were also similar for both groups, the scores being 50 ± 21 and 53 ± 16 for the foot- and hand-activated forceps groups, respectively (p > 0.05, t test). An exit survey of the study's participants revealed that subjects did not have a preference for the hand or foot modality of the forceps tool, with 10 preferring the hand-activated forceps tool and 8 preferring the foot-activated tool. Conclusions: During simulated intraocular surgery, foot- and hand-activated surgical tools appear to have similar performance characteristics and are equally well received by residents. © 2012 Canadian Ophthalmological Society.Link_to_subscribed_fulltex