Saving of Time Using a Software-Based versus a Manual Workflow for Toric Intraocular Lens Calculation and Implantation

Evaluation of the Efficiency of a Digital Workflow for Cataract Planning in Patients with Astigmatism

Purpose

To evaluate the efficiency and associated costs of a digital cataract workflow system and manual cataract workflow system for patients, with astigmatism presenting for cataract surgery in Brisbane, Australia.

Patients and Methods

Sixty patients with bilateral cataract requiring toric intraocular lenses (IOL) were sequentially assigned to a manual cataract workflow (n = 30) or digital workflow (n = 30) using EQ Workplace (SW v1.7.0) running on FORUM (SW v.4.2.1.66) (Carl Zeiss Meditec, Jena, Germany). Each step of preoperative data acquisition and analysis was timed. Steps in each workflow were divided into presurgical planning time and total workflow time, the latter including the time required to input toric data into CALLISTO eye (Carl Zeiss Meditec). Secondary outcomes included staff costs within each workflow.

Results

Median presurgical planning time using a digital workflow process was 6.51 ± 0.65 minutes, and using a manual workflow process, 12.32 ± 0.56 minutes (p < 0.001). Similarly, median total workflow time using a digital workflow process was 6.93 ± 0.57 minutes and using a manual workflow process, 13.49 ± 0.47 minutes (p < 0.001). Evaluating the staff remuneration during presurgical planning and the operating costs associated with running EQ Workplace, there was a cost-reduction of 35% per patient when using the digital cataract workflow process.

Conclusion

Using a digital cataract workflow process is more efficient and provides staff cost-savings compared to a manual workflow process when planning for toric IOL implantation.

Time Savings Using a Digital Workflow versus a Conventional for Intraocular Lens Implantation in a Corporate Chain Hospital Setting

Purpose

To evaluate and compare the digital cataract workflow with the existing conventional workflow in terms of time savings for overall diagnostic procedures from preoperative measurements, data transfer, intraocular lens (IOL) power calculation, and axis marking for cataract surgery in a corporate hospital chain setting.

Patients and Methods

This prospective non-clinical study assessed the mean procedural times for preoperative assessments, calculation of IOL power, data transfer to operating devices, and total surgery for both digital and existing conventional workflows.

Results

Overall, 430 workflows (digital cataract workflow: 227; existing conventional workflow: 203) were included for time measurements. The digital cataract workflow resulted in shorter mean (± standard deviation [SD]) preoperative assessments with lesser variability among individual assessments than the existing workflow (14.15 ± 1.86 vs 21.41 ± 1.18 min, respectively); with a time saving of 35%. Similarly, the mean (± SD) time required for the subsequent assessment steps such as IOL calculation (2.19 ± 1.23 vs 3.17± 2.29 min; 30%), data transfer (0 vs 1.33 ± 0.25 min; 100%), IOL axis marking and alignment (0 vs 3.07 ± 0.53 min; 100%) were shorter with digital cataract workflow versus existing conventional cataract workflow. Briefly, the overall mean time from preoperative assessments to final surgery was 16.48 min with digital cataract workflow and 30.58 min with existing conventional workflow; resulting in a time saving of 46%.

Conclusion

The Zeiss digital cataract workflow demonstrated greater time savings at each step of the cataract surgery workflow compared to the existing conventional workflow. In addition, digitalization can lead to a more streamlined cataract surgery workflow that is more convenient and cost-effective than the existing conventional practices in a corporate chain hospital setting.