Digital versus manual workflows for cataract surgery: a systematic review and meta-analysis.

Introduction: Cataracts are the leading cause of reversible blindness worldwide, with age-related cataracts being the most common type. With advancements in digital workflows, new alternative surgical processes aim to enhance efficiency and patient outcomes.

Objective: This study aimed to evaluate the effectiveness of digital versus manual workflows for cataract surgery through a systematic review and meta-analysis focusing on preoperative assessment time, surgery planning time, intraoperative duration, and transcription frequency.

Methods: The study was performed in accordance with PRISMA guidelines and identified relevant studies published until July 2024 in the PubMed, Embase, Web of Science, and Cochrane databases.

Results: Digital workflows significantly reduced preoperative assessment and intraoperative times for astigmatic cataracts (mean difference (MD)=80.94 s, p<0.01; MD=107.13 s, p=0, respectively) and planning times (MD=130.52 s, p=0.43). Additionally, digital workflows decreased transcription requirements for conventional and post-refractive cataracts. Heterogeneity was notable, especially in the preoperative assessments (I2 >90%).

Conclusion: The findings suggest that digital workflows for cataract surgery improve efficiency; however, further large-scale, long-term studies are required to assess the broader applicability and cost-effectiveness of these workflows. Digitalization has the potential to streamline the surgical management of cataracts and enhance patient outcomes.

Prospero database registration: ID CRD42024590552.