Evaluation of Simulation Ophthalmic Surgery Training Courses in sub-Saharan Africa: What is the impact of this training on students and trainers?

Background: Sub-Saharan Africa (SSA) faces the world’s highest age-standardised prevalence of blindness (0.99%), nearly double the global average. The leading causes—cataract, glaucoma, and diabetic retinopathy—may require surgical interventions. Yet SSA suffers from a significant shortage of ophthalmologists (2.7 per million population) and a lack of access to quality surgical training. Simulated Ophthalmic Surgery (SOS) training provides a promising, safe, and scalable method for early-stage surgeons and trainers to develop critical surgical skills outside live theatre settings. Methods: A cross-sectional, anonymous electronic survey was distributed to 201 trainees and 22 trainers who attended UCT SOS training between 2017 and 2024, exploring demographics, training experiences, perceived impacts, and systemic barriers. Results: The survey received responses from 100 trainees (49.7%) and 18 trainers (81.8%). Trainee worked in 20 SSA countries, with 93% reporting improved confidence, 78% noting fewer complications, and 76% observing better postoperative outcomes. Trainers also benefited: 78% felt more confident in teaching, and 75% observed fewer complications among trainee they later supervised. 65% of trainee and 70% of SSA-based trainers reported inadequate resources for continued simulation practice. Only 50% of trainee could apply their training within one month. Conclusion UCT’s SOS courses significantly enhance surgical and teaching confidence. Institutional barriers such as delayed application, inadequate infrastructure, and limited training time threaten the long-term impact. Simulation-based surgical training shows strong potential for building SSA’s ophthalmic workforce and reducing avoidable blindness. Sustained investment in simulation training infrastructure, policy integration, and structured mentorship attachments is essential to unlock this potential.