Efficiency Comparison Between Two Different Lasers and Cataract Surgery Workflows: A Prospective and Retrospective Analysis.

Abstract

Purpose: To compare time efficiencies between a traditional femtosecond laser platform and workflow and a single-room model with a robotic laser in patients undergoing cataract surgery.

Patients and methods: Single site, prospective, non-masked study of 23 patients (n = 23 eyes) who underwent the femtosecond laser portion of their cataract surgery with the LenSx Femtosecond Laser System (Alcon, Ft. Worth, Texas) in one room and were subsequently moved to a second room for the remainder of their surgery compared to 23 patients who underwent surgery with a dual-modality, robotic laser (ALLY, Lensar, Orlando, FL) and remained in the same room for the rest of the surgery. Time parameters evaluated were laser set up, docking, suction, total laser time, docking attempts, surgeon total case time, patient total case time, transition to phacoemulsification start time, and transition preparation and draping. Third party observers tracked all time and motion parameters by using a stopwatch and documented activities with a time stamp.

Results: There were statistical differences in numerous parameters (all outcomes were measured in minutes): mean suction time [ALLY, 1:16 vs LenSx, 2:26, (P < 0.001)], laser completion to phacoemulsification initiation [ALLY, 0:57 vs LenSx, 4:39, (P < 0.001)], laser set up start to docking start [ALLY, 10:05 vs LenSx, 19:31, (P = 0.034)], total laser time for the surgeon [ALLY, 3:17 vs LenSx, 4:53; (P = <0.001)]; total case time for the surgeon [ALLY, 14:27 vs LenSx,19:40; (P < 0.001)], and total patient time spent in the OR [ALLY, 25:25 vs LenSx 33:22; (P = 0.021)]. There were no statistically significant differences in total phaco procedure time.

Conclusion: Using a robotic laser for cataract surgery can save about 5 minutes of surgeon time per case and 8 minutes of patient's time in the OR when compared to a traditional femtosecond laser platform set up.