Effect of sleep deprivation on the performance of simulated anterior segment surgical skill

Objective: To measure the effect, using a computer simulator, of acute sleep deprivation on the performance of simulated anterior segment surgery skill. Design: Prospective, non-randomized interventional study. Participants: Nine ophthalmology residents (3 residents each from post-graduate years 2, 3, and 4). Methods: Nine ophthalmology residents were tested on the Eyesi surgical simulator on 3 occasions; pre-call or rested (≥7 hours of sleep in previous 24 hours), post-work (8 hour work day and ≥7 hours sleep in previous 24 hours), and post-call or sleep-deprived (<3 hours sleep in previous 24 hours). Residents were tested using the Eyesi forceps module and antitremor module. Level of sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Differences were compared using a 3-factor repeated-measure analysis of variance to account for multiple comparisons. Results: Compared with pre-call and post-work, post-call residents had significantly less sleep in the previous 24 hours (p<0.001) and were significantly sleepier when assessed using the ESS (p<0.001). However, we detected no difference in technical performance using the antitremor module in pre-call (85±21 points), post-work (80±24 points), and post-call (81±27 points; p=0.51) residents or using the forceps module in pre-call (99±1 points), post-work (98±4 points), and post-call (98±5 points; p=0.11) residents. Conclusions: Acute sleep deprivation had no detectable impact on the performance of selected surgical task outcome measures when tested using the Eyesi surgical simulator.