Posters

Retrospective assessment of the use of ICMA in a routine setting for patients undergoing cataract surgery in South Paris University Hospital

Poster Details

First Author: M.Labetoulle FRANCE

Co Author(s): A. Rousseau   E. Barreau   M. M'Garrech   A. Best   M. Legrand   W. Ben Hadj Salah     

Abstract Details

Purpose:

Cataract surgery is one of the most common surgery worldwide, patient preparation and pupil dilation are the bottleneck for combining efficacy in surgical results, safety and optimization of the patient workflow. Intracameral combination of two mydriatics (phenylephrine, tropicamide) and one anaesthetic (lidocaine), (ICMA, Mydrane®, Laboratoires Thea, France), has been launched in 2015 and is now used in routine setting in many centres The study was designed to assess the efficacy, safety and organizational impact of the routine use of ICMA (Mydrane®) in an academic centre in Paris, France.

Setting:

Retrospective, monocenter, observational, chart review of three cohorts of consecutive patients who underwent cataract surgery at three different periods by the same surgeon (Pr. Labetoulle, at South Paris University Hospital, France)

Methods:

Three cohorts of consecutive patients who underwent cataract surgery at the South Paris University Hospital Ambulatory Unit on three different periods were analysed (Cohort 1: just before ICMA became commercially available, Cohort 2: just after ICMA availability, and Cohort 3: around 21 months after). Mean duration of cataract surgery, duration of patient’s stay at surgery facilities, incidence rate of any relevant incident during the surgery, rate of need to perform additional mydriatic solution injection during surgery, mydriasis quality with pupil diameter during intraocular lens (IOL) injection, far mean best corrected visual acuity (BCVA) were evaluated.

Results:

Files of 269 patients were reviewed, among which 51 were eligible for Cohort 1 and 3, and 47 for Cohort 2. Patient populations and IOL types were comparable in the three cohorts. Mean surgery time was significantly decreased from 16.37 minutes (cohort 1) to 13.18 minutes (cohort 3), i.e.after the use of ICMA in routine surgery practice (p<0.05). Concomitantly, mean total room occupancy time was decreased from 39.39 (Cohort 1) to 34.69 (Cohort 3, p<0.05), which allowed a decrease of 6.29 minutes in the mean rotation time between two consecutive patients (p<0.05)

Conclusions:

In our routine use for two years, ICMA was associated with a reduction of the total surgery time. Moreover, we observed a combined decrease of the surgery room occupation time and rotation time between consecutive patients, which allowed an increase in the number of surgeries performed per day. These data add arguments for the cost-effectiveness of this emerging practive in routine cataract surgery centres.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a competing company