Real-time artificial intelligence evaluation of cataract surgery: A preliminary study on demonstration experiment

PURPOSE: We demonstrated real-time evaluation technology for cataract surgery using artificial intelligence (AI) to residents and supervising doctors (doctors), and performed a comparison between the two groups in terms of risk indicators and duration for two of the important processes of surgery, continuous curvilinear capsulorhexis (CCC) and phacoemulsification (Phaco). MATERIALS AND METHODS: Each of three residents with operative experience of fewer than 100 cases, and three supervising doctors with operative experience of 1000 or more cases, performed cataract surgeries on three cases, respectably, a total of 18 cases. The mean values of the risk indicators in the CCC and Phaco processes measured in real-time during the surgery were statistically compared between the residents’ group and the doctors’ group. RESULTS: The mean values (standard deviation) of the risk indicator (the safest, 0 to most risky, 1) for CCC were 0.556 (0.384) in the residents and 0.433 (0.421) in the doctors, those for Phaco were 0.511 (0.423) in the residents and 0.377 (0.406) in the doctors. The doctors’ risk indicators were significantly better in both processes (P = 0.0003, P < 0.0001 by Wilcoxon test). CONCLUSION: We successfully implemented a real-time surgical technique evaluation system for cataract surgery and collected data. The risk indicators were significantly better in the doctors than in the resident's group, suggesting that AI can objectively serve as a new indicator to intraoperatively identify surgical risks.