ABSTRACT
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.
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.
ABSTRACT
PURPOSE: To evaluate the efficacy of trypan blue dye for the staining and removal of the internal limiting membrane, epiretinal membranes, and the posterior hyaloid during pars plana vitrectomy. METHODS: The authors retrospectively reviewed a consecutive series of 26 eyes of 26 patients in whom trypan blue 0.15% dye was used to stain intraocular tissues during vitrectomy surgery. RESULTS: The cases reviewed included the following diagnoses: epiretinal membrane (13), macular hole (9), proliferative vitreoretinopathy (2), chronic pseudophakic cystoid macular edema (1), and chronic diabetic macular edema (1). The application of trypan blue resulted in a useful and consistent bluish staining, facilitating the identification, delineation, and removal of the epiretinal membrane, internal limiting membrane, or posterior hyaloid in all patients. Six months after the surgery, visual acuity was better or the same in 21 of the 26 patients. There were no clinical signs of retinal toxicity in any patients. CONCLUSION: Trypan blue staining of the internal limiting membrane, epiretinal membranes, and the posterior hyaloid is a useful adjunct in vitreoretinal surgery and improves the efficiency and safety of membrane identification and removal.
