Multicenter Evaluation of Time, Operational, and Economic Efficiencies of a New Preloaded Intraocular Lens Delivery System versus Manual Intraocular Lens Delivery

Javier Mendicute; Lucia Bascarán; Luis Pablo; Cédric Schweitzer; Laurent Velasque; Christine Bouchet; Aldo A Martinez

doi:10.2147/OPTH.S263658

Multicenter Evaluation of Time, Operational, and Economic Efficiencies of a New Preloaded Intraocular Lens Delivery System versus Manual Intraocular Lens Delivery

Clin Ophthalmol. 2021 Feb 16:15:591-599. doi: 10.2147/OPTH.S263658. eCollection 2021.

Authors

Javier Mendicute¹, Lucia Bascarán¹, Luis Pablo², Cédric Schweitzer³, Laurent Velasque⁴, Christine Bouchet⁵, Aldo A Martinez⁵

Affiliations

¹ Department of Ophthalmology, Hospital Universitario Donostia, San Sebastián, Spain.
² Department of Ophthalmology, Hospital Universitario Miguel Servet, Zaragoza, Spain.
³ Department of Ophthalmology, Bordeaux University Hospital, Bordeaux, France.
⁴ Centre Retine Gallien, Bordeaux, France.
⁵ Alcon Research LLC, Fort Worth, TX, USA.

Abstract

Purpose: To evaluate intraoperative intraocular lens (IOL) delivery time and total surgical case time using the UltraSert preloaded delivery system (System U) during routine cataract surgeries and to compare with the manually loaded Monarch delivery system (System M). Physician satisfaction with System U was also assessed.

Patients and methods: In this prospective observational study, subjects ≥18 years old underwent cataract surgery in 1 eye and received the AcrySof IQ IOL via the manually loaded System M (n=103) or the AcrySof IQ IOL model AU00T0 via the preloaded System U (n=93). Procedures were digitally recorded by an external camera or by a camera within the operating microscope. Device preparation, IOL delivery, and IOL positioning times were evaluated by 2 independent graders. Pearson χ² test or Fisher exact test was used for categorical variables and Student's t-test or Wilcoxon rank-sum test for continuous variables (all tests were 2-sided and performed at a 5% α-level). Physician satisfaction levels were assessed using questionnaires.

Results: Lens delivery time was similar for System U and System M (12.9±5.1 and 12.2±6.3 s; P=0.412). Mean device preparation time for System U was significantly shorter compared with System M (30.3±6.6 versus 59.8±31.0 s; P<0.05). This resulted in a significantly shorter total intraoperative time (device preparation + lens delivery) with System U versus System M (43.0±8.6 versus 72.0±32.5 s; P<0.05). Total surgical case time (device preparation + lens delivery + lens positioning and unfolding) was shorter for System U versus System M (56.6±12.6 versus 89.6±34.6 s; P<0.05). Physicians reported greater satisfaction levels with System U compared with other devices.

Conclusion: Use of the preloaded delivery system (System U) resulted in faster device preparation and reduced total surgical time compared with the manually loaded system (System M). System U was intuitive to use, and physicians preferred it to other devices.

Keywords: Monarch; UltraSert; cataract surgery; intraocular lens delivery time.

Grants and funding

This study was sponsored by Alcon Research LLC (Fort Worth, TX). The sponsor participated in study design; data management, analysis, and interpretation; and manuscript preparation, review, and approval. IMS Health Solutions France contributed to the management and conduct of the study on behalf of Alcon.