Simulation-Based Training Improves Ophthalmology Resident Confidence in Performing YAG Capsulotomy, Peripheral Iridotomy, and Selective Laser Trabeculoplasty

Abstract

Background and objective Laser-based procedures such as yttrium aluminum garnet (YAG) capsulotomy, peripheral iridotomy (PI), and selective laser trabeculoplasty (SLT) are core competencies in ophthalmology, often involving a significant learning curve. This study assessed the impact of a structured simulation training program in improving ophthalmology residents' confidence in performing YAG capsulotomy, PI, and SLT in the United Kingdom (UK). Methods A prospective study was conducted involving 40 UK ophthalmology residents in their first two years of training, none of whom had prior laser experience. Residents undertook a blended learning program, composed of e-learning modules, instructional videos, and a hands-on workshop using SimulEYE(®) model eyes (insEYEt, LLC, Westlake Village, CA, USA) under the supervision of a consultant. Confidence was assessed before and after training using a 10-point Likert scale. Descriptive statistics and paired Student's t-tests were used to compare pre- and post-training scores. Results Thirty-nine residents completed both pre- and post-training surveys. Following the intervention, resident confidence significantly increased across all three procedures (p < 0.0001). For YAG capsulotomy, the mean confidence score increased from 4.41 to 6.74. Confidence in performing PI rose from 2.82 to 8.21, while confidence in SLT improved from 2.41 to 7.28. Conclusions A structured simulation-based training program was associated with marked improvements in resident confidence across all three laser procedures, particularly for PI and SLT. The blended approach, integrating pre-course theoretical preparation with supervised hands-on simulation, offers an effective and reproducible model for early procedural training. Future studies should evaluate whether these gains are sustained over time and translate into improved clinical performance and patient outcomes.