Table 4.

Nonrandomized trials evaluating efficacy of surgical simulators in improving surgical performance as measured by the same simulator.

Study	Design (OCEBMa level)	Surgical simulator	Participants	Simulated task	Findings
Saleh (2013a) [41]	Case series (4)	EyeSi	Eye residents (n=17)	Cataract surgery	EyeSi training resulted in significantly improved scores (P<.001) among residents, especially for capsulorhexis and antitremor
Gonzalez-Gonzalez (2016) [42]	Case series (4)	EyeSi	Medical students, eye residents (n=14)	Capsulorhexis	EyeSi training resulted in significantly improved course scores for both dominant (33.4 vs. 46.5; P<.05) and nondominant hands (28.9 vs. 47.7; P<.001) and faster performance times (P<.001)
Bozkurt (2018) [43]	Cohort (2b)	EyeSi	Ophthalmologists (n=16)	Capsulorhexis module	EyeSi training resulted in significantly improved capsulorhexis scores (P=.001)
Ropelato (2020) [44]	Case series (4)	Microsoft HoloLens	Unspecified (n=47)	Internal limiting membrane peeling	There was significant improvement in micromanipulation performance scores after simulator-training

^aOCEBM: Oxford Centre for Evidence-Based Medicine.