Can tonic accommodation predict surgical performance?

Surg Endosc. 2003 May;17(5):787-90. doi: 10.1007/s00464-002-9107-0. Epub 2003 Feb 17.


Background: Pilots undergo many visual tests for both selection and assessment, and we know that there are many similarities between pilots and surgeons. Hence, it would not be unreasonable to bring similar visual tests into surgery. Tonic accommodation (TA) is a stable parameter that is adopted by the eye in the absence of any stimulation. Over recent years, surgery has undergone change from traditional open surgery to minimally invasive procedures, bringing many advantages. However, not every surgeon has the ability to perform under conditions where the operative field is represented on a flat monitor.

Method: We determined the TA values in medical students and then correlated this with their performance on a virtual reality surgical simulator.

Results: We found that TA values predicted the number of errors made with the dominant hand, accounting for 27% of the variance.

Conclusion: The data suggest that TA may play a role in the individual differences that are noted when surgeons perform laparoscopic surgery. Further studies are needed to evaluate the exact role of TA in surgical performance.

MeSH terms

  • Accommodation, Ocular / physiology*
  • Adult
  • Clinical Competence / standards*
  • Computer Simulation / standards
  • Computer-Assisted Instruction / methods
  • Educational Measurement / methods
  • Educational Technology / instrumentation
  • Functional Laterality
  • Humans
  • Minimally Invasive Surgical Procedures / education*
  • Minimally Invasive Surgical Procedures / standards*
  • Pilot Projects
  • Predictive Value of Tests
  • Psychomotor Performance
  • Students, Medical