Study of the efficiency and workflow of femtosecond laser-assisted cataract surgery in a Spanish public hospital.
Cataract surgery
Chirurgie de la cataracte assistée par laser femtoseconde
Chirurgie de la cataracte, Phacoémulsification
Femtosecond laser-assisted cataract surgery
Flux de travail en salle d’opération
Lieu public
Operating room workflow
Phacoemulsification
Public setting
Journal
Journal francais d'ophtalmologie
ISSN: 1773-0597
Titre abrégé: J Fr Ophtalmol
Pays: France
ID NLM: 7804128
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
24
09
2020
revised:
07
01
2021
accepted:
10
01
2021
pubmed:
20
7
2021
medline:
30
9
2021
entrez:
19
7
2021
Statut:
ppublish
Résumé
To assess the time-efficiency of a designated operating room (OR) workflow in the introduction of femtosecond laser-assisted cataract surgery (FLACS, LenSx, Alcon®). The study was carried out in a public hospital a with high-volume of procedures. We performed this prospective, controlled, surgical intervention study in the ophthalmology department of a Spanish tertiary referral public hospital. A total of 167 eyes were enrolled, including 62 eyes undergoing conventional phacoemulsification surgery. In phase I, patients were assigned either to FLACS-I (n=63) or conventional phacoemulsification surgery (n=62). One surgeon operated the femtosecond laser, and another completed the procedure, while a third performed conventional phacoemulsification. In the second phase (FLACS-II), all the surgeries were FLACS (n=42). One surgeon performed the FLACS procedure, and two different surgeons completed the surgeries in separate ORs. Surgical and turnover times of all the patients were recorded. Preparation time was statistically significantly lower in FLACS-I and FLACS-II (P<0.001), whereas the duration of the cataract procedure per se was higher in FLACS-II compared to conventional phacoemulsification (P=0.03). Phacoemulsification energy was higher in FLACS-II compared to FLACS-I (P=0.01), whereas laser-related surgical time was lower (P=0.001). Surgical complications and total surgical time showed no statistically significant differences between any of the three groups. This study suggests a time-efficient and suitable workflow model for FLACS, considering the specific requirements and restrictions of a fully booked public hospital. Even so, we have shown that the FLACS procedure does not take longer than conventional phacoemulsification when following a detailed plan for OR workflow. In addition, our data reflect an improvement in FLACS surgical times with ongoing experience. NCT03931629 (retrospectively registered).
Sections du résumé
BACKGROUND
BACKGROUND
To assess the time-efficiency of a designated operating room (OR) workflow in the introduction of femtosecond laser-assisted cataract surgery (FLACS, LenSx, Alcon®). The study was carried out in a public hospital a with high-volume of procedures.
METHODS
METHODS
We performed this prospective, controlled, surgical intervention study in the ophthalmology department of a Spanish tertiary referral public hospital. A total of 167 eyes were enrolled, including 62 eyes undergoing conventional phacoemulsification surgery. In phase I, patients were assigned either to FLACS-I (n=63) or conventional phacoemulsification surgery (n=62). One surgeon operated the femtosecond laser, and another completed the procedure, while a third performed conventional phacoemulsification. In the second phase (FLACS-II), all the surgeries were FLACS (n=42). One surgeon performed the FLACS procedure, and two different surgeons completed the surgeries in separate ORs. Surgical and turnover times of all the patients were recorded.
RESULTS
RESULTS
Preparation time was statistically significantly lower in FLACS-I and FLACS-II (P<0.001), whereas the duration of the cataract procedure per se was higher in FLACS-II compared to conventional phacoemulsification (P=0.03). Phacoemulsification energy was higher in FLACS-II compared to FLACS-I (P=0.01), whereas laser-related surgical time was lower (P=0.001). Surgical complications and total surgical time showed no statistically significant differences between any of the three groups.
CONCLUSIONS
CONCLUSIONS
This study suggests a time-efficient and suitable workflow model for FLACS, considering the specific requirements and restrictions of a fully booked public hospital. Even so, we have shown that the FLACS procedure does not take longer than conventional phacoemulsification when following a detailed plan for OR workflow. In addition, our data reflect an improvement in FLACS surgical times with ongoing experience.
TRIAL REGISTRATION
BACKGROUND
NCT03931629 (retrospectively registered).
Identifiants
pubmed: 34275664
pii: S0181-5512(21)00334-X
doi: 10.1016/j.jfo.2021.01.030
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT03931629']
Types de publication
Controlled Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1190-1201Informations de copyright
Copyright © 2021. Published by Elsevier Masson SAS.