A novel training session: mixed reality evisceration surgery webinar.

Background: Evisceration surgery is an important part of an ophthalmologist's skillset but is an uncommon procedure. Therefore, it is important for training ophthalmologists to have adequate knowledge and confidence in this procedure to maximise learning opportunities. Mixed reality involves the intertwining of real and virtual environments and has been used successfully in surgical training.

Objectives: To improve participants' knowledge of the relevant anatomy, steps and confidence in performing evisceration surgery using an extended reality online webinar coupled with conventional teaching.

Methods: The teaching session comprised of a short lecture introducing evisceration and explaining mixed reality technology including the Microsoft HoloLens headset. This was followed by a 3D demonstration of the orbit and globe, then the live evisceration procedure on a porcine cadaver, with the surgeon's point of view via the headset. There was expert live running commentary during the procedure with the use of virtual signposts on relevant anatomy. Participants were encouraged to be interactive and given the ability to share their annotations on-screen.

Results: Ten doctors ranging from Foundation year 1 to Ophthalmology specialist training year 3 attended the 90-min session and completed pre- and post- session questionnaires (5-point Likert scales). Results showed statistically significant improvements in the knowledge, steps and confidence in performing the evisceration surgery (paired two-sample T-tests, SPSS version 29).

Conclusions: This study has demonstrated that utilisation of mixed reality with conventional teaching methods can provide a useful initial learning experience which may facilitate effective further learning of the evisceration surgery in a wet-lab or patient setting.