Effect of femtosecond laser on efficiency of cataract surgery in public setting

Abstract

ObjectiveTo determine the time needed to perform a femtosecond laser–assisted cataract surgery (FLACS) and its effect on the efficiency of cataract surgery flow in a Canadian public health centre. DesignRetrospective chart review. ParticipantsPatients who had cataract surgery performed in the first 3 months of femtosecond laser (FSL) technology use were compared with patients who had conventional phacoemulsification in the 3 months before FSL installation at Brandon Regional Health Centre (Brandon, Man.). MethodsThe primary outcome measure was the time needed to complete FLACS versus the time needed to complete conventional phacoemulsification. Secondary outcome measures were the time the patient spent in the operating room (time in and time out) and the number of cataract surgeries done per surgical day before and after FSL was implemented systemwide. ResultsThere were 235 FSL cases and 199 conventional cases. Operating room time, total surgery time, and manual time were significantly longer in patients who underwent FLACS compared with patients who underwent conventional phacoemulsification (p < 0.001). Manual times and FSL suction times on the first day of implementing FLACS surgery were significantly longer than those on day 23 (p < 0.03), which suggests a learning curve effect. The number of cases per surgical day dropped by 28.6% in the first operative day and by 7.1% in the second and third operative days of FSL use, then reverted to pre-FSL levels. ConclusionThe addition of FLACS results in longer time per case than traditional cataract surgery. Although statistically significant, the results may not be indicative of practical differences.