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FLACS vs manual phacoemulsification: measuring long-term medical outcome quality using the Quality Index Bellevue(QIB)

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Session Details

Session Title: FLACS II

Session Date/Time: Monday 07/09/2015 | 14:30-16:00

Paper Time: 14:36

Venue: Room 16

First Author: : J.Foerster GERMANY

Co Author(s): :    T. Herbst   D. Holland                 

Abstract Details


The aim of the study is to find out if possible quality differences in medical outcome between FLACS patients and patients being treated with manual phacoemulsification are measurable with the help of a quality measurement system, called “Quality Index Bellevue” (QiB). Therefore, we examined pre-, intra- and postoperative follow-ups up to twelve months. The basis for examinations provides the “Quality Network Bellevue” (QNB). Within the QNB, the Eye Hospital Bellevue is actually connected to 44 established ophthalmologists. With the help of special software, pre- and postoperative findings have been collected for more than 50.000 cases.


The “Quality Index Bellevue System” transfers each medical finding into a quality index and bases upon the German school grading system. The QiB system is built up of three subarea QiBs, which includes measurable and subjectively ascertained findings as well as different aspects of patient satisfaction. Eye Hospital Bellevue, Germany


Our choice of statistical methods depends on the level of measurement: For examinations on aggregate levels, we used ANOVA test as well as ordinary t-test. For comparisons of single finding QiBs, we came back to Mann-Whitney-test and Kruskal-Wallis test respectively because of ordinal scale levels. Further possible examinations will be realized by appropriate statistical methods.


We anticipated finding significant quality differences concerning IOL centration because of a more precise capsulorhexis of the FLACS procedure. Furthermore, we anticipated effective phaco time to be significant lower for FLACS compared to manual phacoemulsification. Patient satisfaction (QiB patient satisfaction) and BCVA / BUCVA (QiB BCVA / QiB BUCVA) may be significant better as well. Our results show significant differences in effective phaco time and in corneal (QiB cornea) and conjunctiva findings (QiB conjunctiva)for 1 day and 1 week postop. Corresponding difference were not significant for the long-term. Furthermore, our first results reject the hypotheses of significant differences concerning patient satisfaction, BCVA, BUCVA and anterior chamber (QiB anterior chamber).


The present study wants to explore the comparative advantages of femto laser-assisted cataract surgery (FLACS) compared to manual phacoemulsification with the help of the “Quality Index Bellevue” (QiB). This measurement system transforms medical findings into school grades and aggregates them to a “QIB overall”. Our first results show significant short-term quality differences in intra- and postoperative findings (phaco time, QIB cornea and QIB conjunctiva). We did not find significant discrepancies in patient satisfaction, BCVA, BUCVA and anterior chamber. Since data ascertainment is still in process, further possible findings will be identified in the context of further statistical analyses.

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