First year experience with femto laser cataract surgery: lessons learned

Session Details

Session Title: Cataract Surgery Outcomes / Femto

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 08:48

Venue: Auditorium

First Author: : W.Trattler USA

Co Author(s): :    C. Buznego              

Abstract Details

Purpose:

To evaluate the impact of the introduction of femto laser cataract surgery (FLCS) with the Lensar platform (Orlando, FL) in an established ophthalmic surgical practice. Prior to the introduction of FLCS, there were a number of expectations and concerns regarding this technology, from the perspective of both surgeons and ambulatory surgical centers (ASCs). From the perspective of the surgeons, expectations included improved clinical results, an increased volume of cataract surgeries, an increased number of premium intraocular lens (IOL) implantations, and increased revenue for their practices. For the ASCs, an increased number of procedures and proportions of surgeon’s cases, the potential to attract new surgeons to the ASCs, improved reputations in their communites, and an increase in ASC revenue were all defined as potential benefits. Concerns voiced by surgeons included increased expenses, increases in procedure/chair time, and loss of “comfort zone.” Concerns for the ASCs included increased capital expenditures, physical space requirements, increased procedure time, reduction in the number of procedures, and training requirements for OR personnel.

Setting:

The study was conducted at a 15 MD, two OD multi-specialty practice located in suburban South Miami Dade. Within the practice, 7 of the 10 cataract surgeons participated; two others do not perform premium intraocular lens (IOL) implantations and one was new to the practice. The ASC is a multi-specialty facility with five rooms, including two “eye rooms,” one housing the FLCS platform.

Methods:

Baseline data at introduction of the FLCS platform (2012) was collected and compared with the same variables approximately one year later (2013). Variables included total volume of cataract surgeries, volume of premium cataract surgeries, and adoption patterns among the surgeons in the practice.

Results:

The practice performed a total of 2117 cataract surgeries in 2012, increasing to 2461 in 2013 (a 16% increase in total volume). FLCS was available for the last 10 months of 2013, and the increase likely reflects both an increased demand for cataract surgery and an increased market share for this ASC. During the same period, total premium cataract surgery increased by 42%. There was a substantial difference in adoption patterns among surgeons in the practice, who essentially fell into three groups: non-adpopters (who were trained in the procedure but stopped performing the procedure), early-adopters, who continuously performed the procedure from the time of their training. A third group was considered to fall somewhere in between. Early- adopters (n=2) had the greatest increase in premium procedures, ranging from increase of 40-99%, while the increase for non-adopters (n=2) ranged from 0% to a 9% decrease in volume. The middle group (n=3) demonstrated an increase ranging between 22-78%.

Conclusions:

Early concerns of surgeons and ASCs have not been seen to be realized. In the evaluated practice, benefits have included increased volume of cataract surgeries, increased premium IOL volume, and increased volume for femto laser surgeons. However, there was a reduction in surgical volume for non-laser surgeons. These findings suggest that surgeons performing laser-based cataract surgery may see in increase in their

Financial Interest:

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