Time Savings Using a Digital Workflow versus a Conventional for Intraocular Lens Implantation in a Corporate Chain Hospital Setting

Purpose

To evaluate and compare the digital cataract workflow with the existing conventional workflow in terms of time savings for overall diagnostic procedures from preoperative measurements, data transfer, intraocular lens (IOL) power calculation, and axis marking for cataract surgery in a corporate hospital chain setting.

Patients and Methods

This prospective non-clinical study assessed the mean procedural times for preoperative assessments, calculation of IOL power, data transfer to operating devices, and total surgery for both digital and existing conventional workflows.

Results

Overall, 430 workflows (digital cataract workflow: 227; existing conventional workflow: 203) were included for time measurements. The digital cataract workflow resulted in shorter mean (± standard deviation [SD]) preoperative assessments with lesser variability among individual assessments than the existing workflow (14.15 ± 1.86 vs 21.41 ± 1.18 min, respectively); with a time saving of 35%. Similarly, the mean (± SD) time required for the subsequent assessment steps such as IOL calculation (2.19 ± 1.23 vs 3.17± 2.29 min; 30%), data transfer (0 vs 1.33 ± 0.25 min; 100%), IOL axis marking and alignment (0 vs 3.07 ± 0.53 min; 100%) were shorter with digital cataract workflow versus existing conventional cataract workflow. Briefly, the overall mean time from preoperative assessments to final surgery was 16.48 min with digital cataract workflow and 30.58 min with existing conventional workflow; resulting in a time saving of 46%.

Conclusion

The Zeiss digital cataract workflow demonstrated greater time savings at each step of the cataract surgery workflow compared to the existing conventional workflow. In addition, digitalization can lead to a more streamlined cataract surgery workflow that is more convenient and cost-effective than the existing conventional practices in a corporate chain hospital setting.

Saving of Time Using a Software-Based versus a Manual Workflow for Toric Intraocular Lens Calculation and Implantation

Background: To determine whether there is a significant saving of time when using a digital cataract workflow for digital data transfer compared to a manual approach of biometry assessment, data export, intraocular lens calculation, and surgery time. Methods: In total, 48 eyes of 24 patients were divided into two groups: 24 eyes were evaluated using a manual approach, whereas another 24 eyes underwent a full digital lens surgery workflow. The primary variables for comparison between both groups were the overall time as well as several time steps starting at optical biometry acquisition until the end of the surgical lens implantation. Other outcomes, such as toric intraocular lens misalignment, reduction of cylinder, surgically induced astigmatism, prediction error, and distance visual acuity were measured. Results: Overall, the total diagnostic and surgical time was reduced from 1364.1 ± 202.6 s in the manual group to 1125.8 ± 183.2 s in the digital group (p < 0.001). The complete time of surgery declined from 756.5 ± 82.3 s to 667.3 ± 56.3 (p < 0.0005). Compared to the manual approach of biometric data export and intraocular lens calculation (76.7 ± 12.3 s) as well as the manual export of the reference image to a portable external storage device (26.8 ± 5.5 s), a highly significant saving of time was achieved (p < 0.0001). Conclusions: Using a software-based digital approach to toric intraocular lens implantation is convenient, more efficient, and thus more economical than a manual workflow in surgery practice.