We congratulate Lee et al. [1] on their recent article that provided a comprehensive overview of technical and non-technical simulation skills in ophthalmology. Eyesi® (VR Magic, Germany) simulator had the best evidence base for its role in cataract surgery training and has been shown to reduce posterior capsular rupture (PCR) rates amongst first and second year surgeons [2].

Recent events have resulted in a prolonged and widespread hiatus of elective surgery and redeployment of staff. This in turn has emphasised simulation as a potential tool that can help surgeons retain and retrain their cataract skills. It is hypothesised that de-skilling due to a surgical hiatus may lead to an increase in complications such as PCR. Although PCR is an infrequent complication, it holds the potential, if poorly managed to result in significant visual morbidity [3]. The impact of simulation on PCR rates is not well known and national access to standardized PCR simulation facilities remains unclear.

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