DOI: 10.1097/j.jcrs.0000000000001999 ISSN: 0886-3350

Comment on: Evaluating large language models vs residents in cataract and refractive surgery: comparative analysis using the American Academy of Ophthalmology Self-Assessment Program

M Vijayasimha, M Srikanth, Logesh Babu

Purpose:

To critically evaluate new evidence regarding big language models (LLMs) in cataract and refractive surgery and suggest a clinically responsible validation system.

Methods:

Conceptual synthesis of the recent literature of high impact and comment on a recent JCRS study on the performance of LLM compared to ophthalmology residents.

Findings:

Despite the high benchmark performance of LLMs, there are still severe deficits in clinical reliability, reproducibility, citation traceability, and safety in anterior-segment procedures. It proposes a three-layer validation pipeline, which includes domain-specific benchmarking, multi-dimensional performance reporting, and use-case-based deployment thresholds.

Conclusions:

It is necessary to shift the accuracy of examination to responsible clinical integration. An equity-sensitive validation framework applicable globally can make the application of AI in cataract and refractive surgery safe, transparent, and effective.

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