Study of the efficiency and workflow of femtosecond laser-assisted cataract surgery in a Spanish public hospital.

BACKGROUND: To assess the time-efficiency of a designated operating room (OR) workflow in the introduction of femtosecond laser-assisted cataract surgery (FLACS, LenSx, Alcon®). The study was carried out in a public hospital a with high-volume of procedures. METHODS: We performed this prospective, controlled, surgical intervention study in the ophthalmology department of a Spanish tertiary referral public hospital. A total of 167 eyes were enrolled, including 62 eyes undergoing conventional phacoemulsification surgery. In phase I, patients were assigned either to FLACS-I (n=63) or conventional phacoemulsification surgery (n=62). One surgeon operated the femtosecond laser, and another completed the procedure, while a third performed conventional phacoemulsification. In the second phase (FLACS-II), all the surgeries were FLACS (n=42). One surgeon performed the FLACS procedure, and two different surgeons completed the surgeries in separate ORs. Surgical and turnover times of all the patients were recorded. RESULTS: Preparation time was statistically significantly lower in FLACS-I and FLACS-II (P<0.001), whereas the duration of the cataract procedure per se was higher in FLACS-II compared to conventional phacoemulsification (P=0.03). Phacoemulsification energy was higher in FLACS-II compared to FLACS-I (P=0.01), whereas laser-related surgical time was lower (P=0.001). Surgical complications and total surgical time showed no statistically significant differences between any of the three groups. CONCLUSIONS: This study suggests a time-efficient and suitable workflow model for FLACS, considering the specific requirements and restrictions of a fully booked public hospital. Even so, we have shown that the FLACS procedure does not take longer than conventional phacoemulsification when following a detailed plan for OR workflow. In addition, our data reflect an improvement in FLACS surgical times with ongoing experience. TRIAL REGISTRATION: NCT03931629 (retrospectively registered).

Tomografía de coherencia óptica en la distrofia macular viteliforme tipo 2 / Optical coherence tomography in vitelliform macular dystrophy type 2

Caso clínico: Presentamos el caso de un niño de 10 años con una distrofia macular viteliforme bilateral, en progresión, y el padre con estadios finales en ambos ojos; se estudia la evolución con la tomografía óptica de coherencia. Discusión: La tomografía óptica de coherencia es una herramienta útil y no invasiva, que permite complementar el diagnóstico y el seguimiento de los pacientes, aportando datos morfológicos de la lesión así como cambios secundarios en la retina adyacente. Demuestra la localización del material amarillento depositado bajo la retina sensorial

Case report: We report the case of a 10-year-old boy with a progressive bilateral vitelliform macular dystrophy, and his father with terminal stage disease in both eyes; we studied the development and progression of this condition with optical coherence tomography. Discussion: Optical coherence tomography is a useful noninvasive tool that complements other diagnostic modalities and improves the follow up assessment. It provides additional information on the morphology of the lesion as well as identifying secondary changes in the adjacent retina. It also demonstrates the location of any yellowish material under the sensory retina (Arch Soc Esp Oftalmol 2008; 83: 501-504)

[Optical coherence tomography in vitelliform macular dystrophy type 2]. / Tomografía de coherencia óptica en la distrofia macular viteliforme tipo 2.

CASE REPORT: We report the case of a 10-year-old boy with a progressive bilateral vitelliform macular dystrophy, and his father with terminal stage disease in both eyes; we studied the development and progression of this condition with optical coherence tomography. DISCUSSION: Optical coherence tomography is a useful noninvasive tool that complements other diagnostic modalities and improves the follow up assessment. It provides additional information on the morphology of the lesion as well as identifying secondary changes in the adjacent retina. It also demonstrates the location of any yellowish material under the sensory retina.