Musical Theater

Music can be a great motivator; it’s why runners listen to it as they pound the pavement and why the Rocky III training montage features the iconic “Eye of the Tiger.” And according to new research, it might also improve the surgical skills of ophthalmologists.

There is a connection between music and cognitive abilities – the so-called ‘Mozart effect’, but how music might affect surgical skills is not well understood. “My colleague and I had always had a passion for music and played it in our operating rooms,” says Ralph Kyrillos, lead author on the associated paper (1). “We’d noticed that preference to operate with music, and opinions on the effect of music on surgical skill varied widely between surgeons. When our hospital acquired an EyeSi simulator we saw an opportunity to actually measure the impact of music on microsurgery.”

According to Kyrillos, the EyeSi offered a great platform to record precise parameters that could not be measured in the real clinical setting. In their prospective study, 14 ophthalmologists and 12 residents stratified by surgical skill were randomized to perform surgical tasks with or without music (Mozart’s Sonata for Two Pianos in D major K.448, in case you’re wondering). “Many of the participants routinely listened to music while operating, but they all had different preferences, such as rock, classical, instrumental – or even letting the patient choose – as well as whether they kept listening to music when performing a complex or delicate part of the procedure,” says Kyrillos. “This made the study really fun, as everyone had a different opinion on the subject and were intrigued what the results would show!”

For the anti-tremor task, the group found no statistically significant differences in recorded parameters between the group exposed to music and the group who were not. For the capsulorhexis task, the ‘total score’ and ‘roundness of capsulorhexis’ parameters showed statistically significant improvements in the group exposed to music (p=0.0249 and p=0.0367, respectively). Subgroup analysis showed no significant differences between surgical experience or between male and female surgeons. A post-hoc analysis identified greater improvements with music in the capsulorhexis parameters ‘total score’ (p=0.0015) and ‘roundness’ (p=0.0021) for participants who hadn’t used the simulator before the study.

Concluding that exposure to music does not negatively impact surgical skills, Kyrillos says they were surprised that listening to music seemed to improve certain scores. “Based on literature describing the ‘Mozart effect,’ we thought music might positively affect skills, but we expected any effect to be minimal and not in the most experienced surgeons who already excelled at surgery.” Kyrillos says that the group actually constructed their study to determine if music had a negative impact on surgical skill: “We thought it would be more useful to find out if we needed to stop listening to music while operating.”

The group studied simulated intraocular surgery, but do their results translate to the real world? “Validation in the real operating world would be hard but not impossible,” says Kyrillos. “Possible ways include comparing complication rates, or filming surgeries and analyzing the videos to measure parameters similar to those recorded by the EyeSi.”

For now, if you listen while you work, you can continue safe in the knowledge that it might actually have some benefit!