Clinical Ophthalmology (May 2024)
Evaluation of the Efficiency of a Digital Workflow for Cataract Planning in Patients with Astigmatism
Abstract
Matthew K Russell,* Yan Inez Hsing* OKKO Eye Specialist Centre, Brisbane, QLD, Australia*These authors contributed equally to this workCorrespondence: Yan Inez Hsing, OKKO Eye Specialist Centre, Level 1, 401 Milton Road, Auchenflower, QLD, 4066, Australia, Tel +617 3725 0222, Email [email protected]: 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.Plain Language Summary: The prevalence of both cataracts and cataract surgery is known to be increasing in Australia and other economically developed countries. During cataract surgery, an individual’s natural lens is removed, and an artificial lens (known as an intraocular lens or IOL) is inserted. Many patients elect to correct their astigmatism at the time of their cataract surgery by choosing to have a specific type of IOL, called a toric lens, implanted, which should reduce their dependence on spectacles following surgery. Ophthalmology clinics and clinical staff can spend significant time accurately planning and selecting a toric IOL in preparation for surgery. We evaluated the time spent on toric IOL planning in a digital workflow versus a manual workflow. There was a significant reduction in time (and therefore reduced staffing costs) with the digital workflow. Digital workflows offer improved efficiency and can be more cost-effective, both of which are important when meeting the increasing demands and rates of cataract surgery.Keywords: cataract, astigmatism, workflow
