Study quantifies time gained by immediate sequential bilateral cataract surgery
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A time and motion study conducted at St. Thomas’ Hospital in London quantified time saving related to immediate sequential bilateral cataract surgery compared with consecutive unilateral cases.
“In ophthalmology, we are faced with a growing aging population and the demand for cataract surgery continues to increase. An additional way in which we can further tackle this growing demand is more efficient utilization of [immediate sequential bilateral cataract surgery] ISBCS,” Khayam Naderi, MD, said at the virtual European Society of Cataract and Refractive Surgeons winter meeting.
Five theater lists consisting of only ISBCS cases were compared with five lists with only unilateral cases (UC). The individual tasks and duration of tasks by each member of the surgical team, including the operating surgeon, were recorded in real time by two observers.
The median number of eyes operated per 4-hour list was eight in the ISBCS group compared with five in the UC group. The mean total theater time, defined as time between the entry of the first patient and the exit of the last patient, was 139.16 minutes in the ISBCS group vs. 177.12 minutes in the UC group. The patient turnover, defined as the removal of the surgical speculum from the eye of the first patient and the insertion of the speculum into the eye of the next patient, was 7.29 minutes in the ISBCS group vs. 12.14 minutes in the UC group.
“Based on our findings, we can expect a 13.3% reduction in the time taken to perform two cataract operations in an ISBCS case as compared to two unilateral cases. This would allow for one extra unilateral case performed every four ISBCS cases,” Naderi said.
To conclude, he pointed out the value of time and motion studies as a way to investigate surgical productivity in any unit in the world and to test theoretical models for efficiency improvements.
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Naderi K. FB63. Presented at: European Society of Cataract and Refractive Surgeons winter meeting; Feb. 18-20, 2022 (virtual meeting).
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