{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:24:40Z","timestamp":1789575880369,"version":"build-2803163510"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extended reality (XR) simulation offers repeatable, risk-free practice for ophthalmic training. We conducted a systematic review and meta-analysis to quantify its effects on training outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched MEDLINE (PubMed), Embase, Web of Science Core Collection, and Cochrane CENTRAL from inception to February 6, 2026. Risk of bias was assessed using RoB 2 (randomized trials) and ROBINS-I (non-randomized studies), and certainty of evidence was evaluated with GRADE. Statistical analysis was performed using Stata 15.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-two studies (1,572 trainees) were included. XR training significantly reduced overall intraoperative complications (OR = 0.72; 95% CI, 0.63\u20130.82;\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), posterior capsule rupture (OR = 0.63; 95% CI, 0.49\u20130.81;\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), and CCC-related complications (OR = 0.44; 95% CI, 0.21\u20130.90;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.024). Vitreous loss and retained lens material did not differ significantly. Technical performance improved, with higher global surgical scores (SMD = 1.93; 95% CI, 1.49\u20132.38;\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and CCC scores (SMD = 0.73;\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Total operative time was significantly shortened (WMD = \u22128.92 min; 95% CI, \u221216.38 to \u22121.46;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.019). Trainee confidence generally improved, though perceived realism varied.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Extended reality (XR) simulation training can enhance ophthalmic surgical technical performance and procedural efficiency, reduce the risk of intraoperative complications, and improve trainees' operative confidence. These findings provide an evidence-based foundation for the design and optimization of ophthalmology training curricula. Future studies should further investigate the value of XR technologies in non-cataract procedures and in the development of non-technical skills.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier: CRD420261288204.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1823359","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:18:59Z","timestamp":1777609139000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of extended reality (XR) simulation on ophthalmology training outcomes: an updated systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuxi","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengfang","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilian","family":"Ke","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e489","DOI":"10.25259\/IHOPEJO_15_2021","article-title":"The Lancet Global Health Commission on Global Eye Health: vision beyond 2020","volume":"9","author":"Burton","year":"2021","journal-title":"Lancet Glob Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1136\/bjo-2025-327776","article-title":"Global trends in cataract burden: a 30-year epidemiological analysis and prediction of 2050 from the Global Burden of Disease 2021 study","volume":"110","author":"Jiang","year":"2026","journal-title":"Br J Ophthalmol."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/aos.17575","article-title":"Competency-based European training requirements for the specialty of ophthalmology. 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