ASCRS 2024: Workflow and cost savings utilizing an all sterile femtosecond laser-assisted cataract surgery

Neda Nikpoor, MD, sat down to discuss her presentation on "prospective analysis of time workflow and cost savings utilizing an all sterile femtosecond laser-assisted cataract surgery and phaco model," at this year's ASCRS meeting held in Boston, Massachusetts.

Video Transcript

Editor's note - This transcript has been edited for clarity.

David Hutton:

I'm David Hutton of Ophthalmology Times. ASCRS is holding its annual meeting this year in Boston. At that meeting, Dr. Neda Nikpoor shared a study titled "Prospective analysis of time workflow and cost savings utilizing an all sterile femtosecond laser-assisted cataract surgery and phaco model." Thank you so much for joining us today. Tell us a little bit about this study.

Neda Nikpoor, MD

Oh, thanks for having me. Yeah, I'm excited to talk to you about this study. This was something that we are very excited to present. So we've been using the ALLY laser by Lensar for quite a while now, since it first came out. And initially we were using a nonsterile feeder model. And we believed that a sterile model with two ALLYs, in two operating rooms would be more efficient allowing the surgeon to move from room to room without the delay caused by the turnover time in between the laser and the procedure and without having to actually move the patient from the laser to a different OR in a model where you would only have one laser for two rooms. So we had a prospective single-site study. And we included all patients that were undergoing uncomplicated phaco with femto. We did 24 sterile patients and 13 nonsterile patients. Our endpoints that we were looking at were surgeon total case time, as well as patient total case time. So that was how long was the surgeon actually hands-on with the patient. And then how long was the patient in the operating room for everything, including, you know, the prep and drape and all that kind of stuff. And what we found was that there was a statistically significant difference between both of those endpoints. So with surgeon total case time, we found for the sterile cases, it was 12 minutes and 25 seconds. And for the nonsterile cases, it was 19 minutes and 13 seconds for patient total case, time, sterile was 20 minutes and 56 seconds and nonsterile was 34 minutes and 37 seconds. So you can see that's a huge difference. And if you really do the math on that, what you see is that with a sterile procedure, you save seven minutes of surgeon total case time and 14 minutes of patient in the OR time. So what that means is you could be doing five more cases, five cases per hour, instead of three cases per hour if you're using sterile versus a feeder model. And or you can just enter day early and then you could have another surgeon follow you or go do whatever else you want. The ALLY allows for phaco to be performed in a sterile setting, which is more efficient than a nonsterile feeder model.

David Hutton:

Ultimately, what can this mean for patients?

Neda Nikpoor, MD

That's a great question, so one of the things that I find is for patients when you do the laser part, and then you have a gap in time, between the laser and the phaco, they're kind of having to go through this start of a procedure twice. And there's always anxiety with starting a procedure. And so if you can make it one continuous, seamless procedure for the patient, it's a much better experience. That's what I've seen. And that's what you know, I feel patients could have kind of expressed in so many ways. So yeah, I definitely think it's a better experience for the patient. And for the surgeon, it's a much better experience, because you're not trying to keep track of where's your patient? Who is this patient? What did I just finished doing? And I feel like sometimes when there's this, you know, feeder model, the surgeon is kind of running around from room to room and out to pre op and back. And this way you just walk in, you start one patient, you end one patient. There's no juggling multiple patients at one time, which is really nice and a lot, a lot more calming, I think.

David Hutton:

And lastly, is there a next step to this research?

Neda Nikpoor, MD

Yeah, we would like to actually explore other ways of improving efficiency. And so we're looking at optimizing certain things on the laser. Optimizing certain–potentially going to come out in another study, but we're looking at improved being things like the draping and the different hardware features that could make the laser even more efficient when done in a sterile fashion.