Surgical Time for Uncomplicated Cataract Procedures on 2 Surgical Platforms

Monday, April 28, 2014: 1:06 PM
Room 151B (Boston Convention and Exhibition Center)
Barry A. Schechter, MD, Florida Eye Microsurgical Institute, Boynton Beach, Florida, USA

Narrative Responses:

Purpose
To compare the surgical times for uncomplicated cataract surgery performed on two Bausch + Lomb phacoemulsification systems--the Stellaris system and the previous generation Millennium system.

Methods
This retrospective comparison study involved 3 surgeons at a single site. Six surgery days with at least 12 uncomplicated procedures each day (no LRIs , vitrectomies or intraoperative devices) were randomly selected for each surgeon, 3 with procedures performed using the Millennium system and 3 with procedures performed using the Stellaris system 3 months later after the surgical center upgraded to the new system. The surgical technique, operating room staff, incision sizes, intraocular lenses implanted, and viscoelastic used were unchanged. The time for procedures was evaluated for each surgeon on each machine and compared among surgeons and between machines.

Results
Upgrades on the Stellaris system from the previous Millennium system include improvements in response time and fluidics, an increased stroke length, a wireless foot pedal, and a more ergonomic hand piece. Each surgeon had a similar learning curve on the Stellaris. Over the first 45 cases, surgical time decreased by an average of 0.34 min for every 10 cases operated, then plateaued. Overall, the mean (± SEM) time per surgery was 8.42 ± 0.17 min with the Millennium vs 6.58 ± 0.21 min (after case # 45) with the Stellaris. The difference between machines was clinically and statistically significant (p<0.001).

Conclusion
Improvements in fluidics and cutting efficiency with the Stellaris system decreased surgical time by 22% compared with the previous generation Millennium system.Surgeons may increase their efficiency in the operating room and improve patient flow by switching to the Stellaris phacoemulsification machine from the Millennium model.