Impact of a Swept Source-Optical Coherence Tomography Device on Efficiency in Cataract Evaluation and Surgery: A Time-and-Motion Study

Abstract

Purpose

This study aims to assess the time impact of ARGOS^® (image-guided swept-source optical coherence tomography biometer integrated with operating room (OR) technologies (SS-OCT w/ORT)) compared to LENSTAR LS 900 (optical low-coherence reflectometry (OLCR)), IOLMaster 500 (partial coherence interferometry (PCI)), and IOLMaster 700 (SS-OCT) on efficiency in the cataract evaluation and surgery.

Patients and Methods

Data from 212 patients (two study sites) who underwent evaluation and/or cataract surgery were collected. The primary objective was to compare the performance of four biometers; statistical analyses were conducted to compare 1) biometer measurement times for all patients (ANOVA w/post-hoc Dunnett’s test) and stratified by cataract density (ANOVA) and 2) rate of biometer acquisition failure (Chi-square test w/post-hoc Bonferroni correction). Real-world observational data collected were then used to develop a practice-based time-efficiency model to demonstrate the combined effect that adopting an SS-OCT w/ORT has on a practice’s cataract workflow. Real-world data inputs included assessment of patient’s eyes’ cataract grade density, time taken for optical biometry, Manual A-scan (ultrasound biometer) when acquisition failed, and measurement times associated with other devices used in cataract evaluation and surgery.

Results

For 208 patients (56% non-dense, 44% dense), the SS-OCT w/ORT biometer had a 0% acquisition failure (SS-OCT: 3% (p = 0.05); OLCR: 5% (p = 0.004); PCI: 15% (p < 0.0001)) and an average time savings of 30 seconds/patient compared to the other biometers in this study (p < 0.05). When acquisition failed, ultrasound biometry resulted in an additional 2.5 minutes/patient. For a cohort of 1000 patients, an SS-OCT w/ORT and an image-guidance system adopted at a practice using an SS-OCT, femtosecond laser, and intraoperative aberrometer offer up to 58% efficiency gain across the cataract workflow.

Conclusion

Results from this study demonstrate an SS-OCT w/ORT’s efficiencies in cataract evaluation and surgery driven by faster measurement times, reducing the need for ultrasound biometry, and its integration benefits with other devices.

Keywords:

• cataract surgery
• swept-source optical coherence tomography biometer
• time-and-motion study
• preoperative evaluation phase

View correction statement:

Impact of a Swept Source-Optical Coherence Tomography Device on Efficiency in Cataract Evaluation and Surgery: A Time-and-Motion Study [Corrigendum]

Abbreviations

AT-IOL, advanced-technology intraocular lens; BMI, body mass index; IRB, Institutional Review Board; IQR, interquartile range; IOL, intraocular lens; LOCS, Lens Opacity Classification System III; M, meter; NS, Nuclear Sclerosis; OR, operating room; OLCR, optical low-coherence reflectometry; ORA, Optiwave Refractive Analysis; PCI, partial coherence interferometry; PHI, protected health information; S, second; SD, standard deviation; SS-OCT, swept-source optical coherence tomography biometer; SS-OCT w/ORT, swept-source optical coherence tomography biometer integrated with operating room technologies.

Disclosure

Li-Chen Pan and Sean Timmons are employed by Boston Healthcare Associates (a Veranex Company), and at the time this research was performed Manasi Datar was employed by Boston Healthcare Associates. Dr Datar reports that under consulting agreements with RenalytixAI and Foundation Medicine, Veranex received funds to conduct research. Chia-Wen Hsiao, Sun-Ming Pan, and Raiju Babu are employees of Alcon. Dr. Multack and Dr. Woodard are consultants for Alcon. The authors report no other conflicts of interest in this work.

Additional information

Funding

This study was funded by a research grant from Alcon.