{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:05:41Z","timestamp":1790697941580,"version":"4.1.0"},"reference-count":39,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    To investigate differences in gaze behavior among vitreoretinal surgeons of varying experience levels during simulated pars plana vitrectomy with epiretinal membrane peeling using a 3-dimensional heads-up display (HUD) system with integrated eye-tracking.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Twenty-six ophthalmologists\u2014postgraduate year 4 residents (n\u2009=\u200910), vitreoretinal fellows (n\u2009=\u20099), and attending surgeons (n\u2009=\u20097)\u2014performed simulated vitrectomy on model eyes using a 3-dimensional HUD system with eye-tracking. Gaze metrics (fixations, saccades, field awareness, HUD focus, and tear angle) and surgical performance (International Council of Ophthalmology, Ophthalmology Surgical Competency Assessment Rubric vitrectomy score) were evaluated. Statistical analysis included Pearson correlation, analysis of variance (ANOVA), and post hoc Tukey tests.\n                    <jats:bold>Results:<\/jats:bold>\n                    Surgical performance increased with experience (postgraduate year 4: 26.6\u2009\u00b1\u20091.3; attending: 42.5\u2009\u00b1\u20091.6;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.0001). Attendings demonstrated fewer fixations (3454.0\u2009\u00b1\u2009548.0 vs postgraduate year 4: 6114.0\u2009\u00b1\u20091349.0;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.0001), shorter fixation durations (0.21\u2009\u00b1\u20090.015 seconds vs 0.277\u2009\u00b1\u20090.034 seconds;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.05), and smaller saccade lengths (0.168\u00b0\u2009\u00b1\u20090.082\u00b0 vs 0.325\u00b0\u2009\u00b1\u20090.094\u00b0;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.01). They also showed greater HUD utilization (76.3%\u2009\u00b1\u20097.3% vs postgraduate year 4: 45.0%\u2009\u00b1\u20098.9%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.01), broader visual field awareness (51.3%\u2009\u00b1\u20099.7% vs 17.3%\u2009\u00b1\u20095.7%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001), and more controlled membrane peel angles (7.1\u00b0\u2009\u00b1\u20092.6\u00b0 vs postgraduate year 4: 89.5\u00b0\u2009\u00b1\u200922.6\u00b0). Novices primarily focused on instrument tips, whereas experts exhibited feed-forward gaze strategies with anchored fixation and situational awareness.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Expert vitreoretinal surgeons demonstrate distinct visual strategies characterized by efficient gaze behavior, broad field awareness, and HUD-focused attention. These gaze patterns correlate with surgical proficiency and may serve as benchmarks for training. Eye-tracking integrated with HUD systems may enhance surgical education by allowing trainees to model expert gaze behavior and improve operative performance.\n                  <\/jats:p>","DOI":"10.1177\/24741264251404735","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T01:12:39Z","timestamp":1767057159000},"page":"418-426","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of Surgeon Gaze Characteristics During Pars Plana Vitrectomy and Membrane Peeling"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2629-0416","authenticated-orcid":false,"given":"Puranjay","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Alahmadi","sequence":"additional","affiliation":[{"name":"Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3456-0164","authenticated-orcid":false,"given":"Michael J.","family":"Heiferman","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"issue":"7","key":"e_1_3_2_2_2","first-page":"4186","article-title":"Epidemiology of common retinal diseases in retina practices in the United States","volume":"61","author":"Rosenblatt T","year":"2020","unstructured":"Rosenblatt T, Vail D, Saroj N, Boucher N, Moshfeghi D, Moshfeghi AA. Epidemiology of common retinal diseases in retina practices in the United States. Invest Ophthalmol Vis Sci. 2020;61(7):4186.","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S262131"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1741461"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD014953.pub2"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10030456"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-079917"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2019.100710"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2400-7"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.16910\/jemr.14.2.2"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/ans.18686"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S290396"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3928\/23258160-20250228-03"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-023-02794-4"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-023-10409-y"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2023.107720"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1021\/bk-2018-1292.ch001"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17010030"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.16910\/jemr.13.6.1"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/s22031187"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1145\/2993901.2993908"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.675700"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1553350616639141"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4713-9"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2006.11.010"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318220ef31"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.07.033"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-001-0133-1"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2018.06.022"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.18240\/ijo.2022.04.10"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.25259\/GJCSRO_26_2023"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-82377-9"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2014-306065"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_1728_18"},{"key":"e_1_3_2_35_2","unstructured":"Rajabi MT Tari AS Jabbarvand M Rajabi MB. Reappraisal of the capsulorhexis: tearing angle in capsulorhexis. Int J Ophthalmol. 2009;2(3):266-270. Accessed February 8 2025. https:\/\/dr-jabarvand.com\/wp-content\/uploads\/2017\/12\/Areappraisal-of-the-capsulorhexis-Tearing-angle-in-capsulorhexis.pdf"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-018-0416-1"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrab068"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-1546-4"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-011-1802-2"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/1553350607302329"}],"container-title":["Journal of VitreoRetinal Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24741264251404735","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24741264251404735","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24741264251404735","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:24:42Z","timestamp":1790695482000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24741264251404735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,29]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/24741264251404735"],"URL":"https:\/\/doi.org\/10.1177\/24741264251404735","relation":{},"ISSN":["2474-1264","2474-1272"],"issn-type":[{"value":"2474-1264","type":"print"},{"value":"2474-1272","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,29]]}}}