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RESULTS We found significant improvement in micromanipulation performance in the first training session with both the ITS and classic training. In the second session, however, only the participants training with the ITS had further improvements in performance. CONCLUSIONS Results of this study demonstrate the usability of AR simulation in training micromanipulation skills and support the claim that simulators can be used in ophthalmic surgery training. This study also extends the existing literature by demonstrating an application of ITS