Objective:

To assess the impact of extended reality (XR) simulations on various training outcomes in ophthalmology, including technical proficiency and complication rates.

Key Findings:

• XR education significantly reduced overall intraoperative complications (OR = 0.72; 95% CI, 0.63–0.82; P < 0.001).
• Posterior capsule rupture incidents decreased (OR = 0.63; 95% CI, 0.49–0.81; P < 0.001).
• Technical execution improved with higher global surgical scores (SMD = 1.93; 95% CI, 1.49–2.38; P < 0.001).
• Overall operative duration was significantly reduced (WMD = -8.92 min; 95% CI, -16.38 to -1.46; P = 0.019).
• Trainee confidence generally increased, though perceived realism varied.

Interpretation:

XR simulation training enhances surgical technical proficiency and reduces intraoperative complications, indicating a strong case for its integration into ophthalmology training programs.

Limitations:

• Variability in XR simulation exposure among trainees may affect the generalizability of the findings.
• Inconsistent implementation across training programs limits the ability to draw broad conclusions.
• High costs and logistical challenges in low-resource settings hinder widespread adoption.

Conclusion:

XR simulation training has the potential to improve ophthalmic surgical training outcomes, warranting further research into its application in other procedures and non-technical skills, particularly in diverse training environments.