Influence of distractions and meditation on the surgical performance of vitreoretinal surgeons using the EyeSi Simulator

PURPOSE: Vitreoretinal surgery is a highly technical subspecialty that requires exceptional precision and concentration. External factors, such as distractions and meditation, have been identified as potential influencing factors of surgical performance across various microsurgical specialties. This study assesses the effects of distractions and meditation on the performance of senior vitreoretinal surgeons using a validated surgical simulator. METHODS: A multicentre prospective interventional study was conducted with fully trained vitreoretinal surgeons (n = 10). Three validated modules resembling posterior eye surgery were completed under three different conditions. Distractions were simulated via clinical questioning, while meditation consisted of guided one-minute breathing exercises. These were compared to a baseline performance where the candidate could complete the modules undisturbed. Performance metrics were analysed (baseline vs intervention) using a Wilcoxon signed-rank test. RESULTS: Distractions significantly reduced overall task scores in two out of three modules (p < 0.001). Meditation did not significantly improve performance scores across the modules. Distractions consistently increased task completion time across all modules (p < 0.001), whereas meditation only reduced time significantly in one module (p = 0.007). CONCLUSION: Distractions negatively impacted surgical performance, increasing errors and prolonging task duration. Meditation showed limited but positive effects. Minimizing distractions during surgery is essential to optimize surgical outcomes.