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Laser-assisted cataract surgery vs conventional phacoemulsification: is there a measurable quality difference in longitudinal outcome?

Poster Details

First Author: T.Herbst GERMANY

Co Author(s):    J. Foerster   D. Holland   F. Ruefer              

Abstract Details


On the basis of already presented results on ESCRS in Ljubljana, the aim of the study is to find out if possible differences in quality of medical treatments between femto phaco patients and conventional phaco patients are measurable with the help of a quality measurement system, called �â�€�œQuality Index Bellevue�â�€� (QiB). Therefore, we examined pre- intra- and postoperative follow-ups up to six months. The basis for examinations provides the �â�€�œQuality Network Bellevue�â�€� (QNB). Within the QNB, the Eye Hospital Bellevue is actually connected to 44 established ophthalmologists.


The base for examinations is �â�€�œQuality Index Bellevue System�â�€�, which transfers each medical finding into a quality index and bases upon the German school grading system. QiB system is built up of three subarea QiBs, which includes measurable and subjectively ascertained findings as well as different aspects of patient satisfaction.


Our choice of statistical methods depends on the level of measurement: For examinations on aggregate levels, we will use ANOVA test as well as ordinary t-test. For comparisons of single finding QiBs, we will come 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 effective phaco time to be significant lower for femto phaco compared to conventional cataract procedure. As a consequence, �â�€�œQiB anterior chamber�â�€� should be better for femto phaco procedure. Further possible advantages are anticipated in a relative improved cornea finding because of less endothelial cell loss. Patient satisfaction (QiB patient satisfaction) and BCVA / BUCVA may be significant better as well. We found significant differences in effective phaco time, endothelial cell loss (QiB cornea) and IOL centration (QiB IOL). Our first results reject the hypotheses of significant differences concerning patient satisfaction, BCVA, BUCVA and anterior chamber (QiB anterior chamber).


Laser-assited cataract surgery seems to be a momentously step in cataract surgery. The present study wants to explore the comparative advantages of this technic with the help of �â�€�œQuality Index Bellevue�â�€� (QiB). This instrument of quality measurements rates the quality of medical output with the help of postoperative findings. Our first results show significant quality differences in three intra- and postoperative findings (phaco time, endothelial cell loss, IOL centration). Since data ascertainment is still in process, further possible findings will be identified in the context of following statistical analyses.

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