Femtosecond laser-assisted cataract surgery in a public hospital: efficiency of femtosecond laser-assisted cataract surgery vs conventional phacoemulsification

Session Details

Session Title: Presented Poster Session: FLACS

Venue: Poster Village: Pod 1

First Author: : M.Rodriguez Calvo de Mora SPAIN

Co Author(s): :    C. Perez Casaseca   E. Espejo de los Riscos   G. Fernandez-Baca Vaca                 

Abstract Details

Purpose:

To assess the time-efficiency of a designated operation room (OR) workflow in the introduction of Femtosecond laser-assisted cataract surgery (FLACS, LenSx, Alcon). The study was carried out in a public hospital with high volume of procedures (21 cataracts per session, 7 per OR) where the population presents specific characteristics as advanced age, hard cataracts and multiple concomitant ocular and systemic diseases.

Setting:

Ophthalmology department of a tertiary referral Spanish public hospital.

Methods:

In phase I, patients were assigned to FLACS-I (n=59) or phaco-surgery (n=57). One surgeon performed the Femto-second procedures (Fs) and another finished the cataract surgeries in different OR. Simultaneously, a third surgeon (control) performed conventional phacoemulsification in other OR. Surgeons changed their positions in each surgical session to avoid biases. In phase II (FLACS-II), all the surgeries were performed with FLACS (n=26). One surgeon performed the Fs procedure and two different surgeons completed the surgeries in separated ORs. Surgical and roll-over times of all the patients were recorded. More complicated cataracts were performed in phase II compared to phase I.

Results:

Preparation time was statistically significant lower in FLACS-I and FLACS-II (p<0.001) than conventional phaco. Although, the time of the cataract surgery did not differ between FLACS I and conventional phacoemulsification, it was higher in FLACS-II (p= 0.03). Phacoemulsification energy was higher in FLACS-II compared to FLACS-I (p = 0.01) whereas laser-related surgical time was lower in FLACS II (p = 0.001). Surgical complications showed no statistically significant differences (p = 0.56). Total time in the OR did not show statistically significant differences between the three groups.

Conclusions:

Despite that FLACS overall procedure does not take longer than conventional phacoemulsification, this study shows that a suitable workflow for FLACS can reduce timing on the patients' surgical preparation. The fact that the time of the cataract surgery and the phacoemulsification energy was higher for FLACS-II than FLACS-I and conventional technique might be attributed to the more challenging cataract included in FLACS-II group. There was reduction on the laser-related surgical time between FLACS-I and FLACS-II indicating a learning curve improvement with experience.

Financial Disclosure:

None