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

Abstract

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.

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

“…Time saving and reducing potential errors during manual transcription are vital for overall productivity and outcomes. 9 In line with earlier observations, 9 , 11 digital cataract workflow demonstrated significant time savings due to the automatic transfer of biometric data, IOL power calculation, and the reference image import to the intraoperative devices through a cloud-based platform. In contrast, in the conventional method, the biometric data are double-checked, and the reference image is manually transferred to the intraoperative device through a USB stick.…”

“…Previous studies have also sought to assess the impact of digitalization or software integration on the cataract surgery workflow. 9 , 11 A time-and-motion study demonstrated that swept-source OCT integrated with the operating room resulted in quicker measurement times. 13 …”

“…Given the global increase in the volume of cataract surgeries, there is a mounting need for a digitally supported surgical workflow that would enable surgeons to handle high patient volumes with automated and efficient IOL power calculation, short operative time, and greater patient satisfaction. 10 , 11 Recent studies have reported a few advancements, such as cloud-based surgical planning software, 9 computer-assisted toric IOL axis alignment and marking, 12 and digital cataract surgery workflow; 11 however, with a limited number of patients. In this regard, pre- and intraoperative diagnostics integrated into one digital workflow would help deliver quality outcomes in a short duration and save resources required for cataract surgery.…”

“…The digital cataract workflow allows preoperative measurements, selects IOL, aligns IOL axis, and exports data to intraoperative surgical devices. 11 The present study aimed to evaluate and compare the digital cataract workflow with the existing conventional workflow in terms of time savings for the overall preoperative assessments, data transfer, IOL power calculation, axis marking and alignment, and surgery in a corporate hospital chain setting.…”

Evaluation of the Efficiency of a Digital Workflow for Cataract Planning in Patients with Astigmatism

“…Brunner et al recently found that both diagnostic and surgical times were reduced when using a digital workflow process on one eye compared to a manual process on the fellow eye. 12 The purpose of this study was to assess if the incorporation of a digital workflow would reduce the time spent and costs associated with the preoperative processes necessary for toric IOL calculation when compared to a manual workflow process.…”