Predictive and construct validity of virtual reality cataract surgery simulators

Zacharia H. Nayer, The George Washington University
Braedon Murdock
Ishaan P. Dharia
David A. Belyea


This review was conducted to assess the current literature on virtual reality (VR) simulation in cataract surgery training. Studies evaluating the construct and predictive validity of VR simulators, such as the EyeSi simulator, were compiled and compared. Two databases, PubMed and Scopus, were systematically searched, and 20 articles were determined to meet the study inclusion criteria (full-length articles written in English). Of these, 11 studies examined construct validity, and 9 studies examined predictive validity. Although the construct validity of some VR simulators is yet to be established by multiple studies, many of the modules within the EyeSi simulator have been repeatedly validated. Furthermore, several studies have shown that VR simulator training improves overall cataract surgery performance. This review demonstrated the ability of cataract surgery VR simulators to differentiate surgical experience levels and improve operating room performance, which supports the use of VR simulators in ophthalmology residency training.