Time Efficiency Metrics of an Innovative Swept Source OCT Biometer (SS-OCT) for Cataract Evaluation: A Comparative Time-and-Motion Study

My name is Dr. Sam Multack. I am in private practice in the metro Chicago area, where I specialize in advanced cataract procedures and minimally invasive glaucoma surgery. My colleagues and I recently conducted a time-and-motion study comparing efficiency metrics with the ARGOS® Swept-Source Optical Tomography (or SS-OCT) biometer to three other optical biometers: the IOLMaster^ 700, the LENSTAR^ LS 900, and IOLMaster^ 500. To get an understanding of how these biometers performed in a real-world patient population, we evaluated outcomes in patients with non-dense and dense cataracts. This was a within-subjects, observational time-and-motion study in 188 adult patients undergoing cataract evaluation at a single surgical site. All four biometers were used to collect measurements in each patient, in randomized order and with a 90-second interval between measurements. Cataract density was assessed using LOCS-III grading. Outcomes of interest were biometric measurement time, axial length acquisition failure rate, and in the case of acquisition failure, Manual A-scan measurement time. Across the entire study population, the ARGOS® biometer had a 0% acquisition failure rate. In contrast, failure rates ranged from 3 to 15% with the IOLMaster^ and LENSTAR^ biometers. ARGOS® was statistically superior to the comparator biometers in this respect. Mean measurement time with ARGOS® was just over one minute — was also significantly shorter than those observed with the other biometers. When we stratified the data by cataract density, we saw similar results. Acquisition failure rate with ARGOS® was 0% in both scenarios. The IOLMaster^ 700 performed similarly for non-dense cataracts, with an acquisition failure rate of 0%, but it had a failure rate of 6% for dense cataracts. The LENSTAR^ biometer had acquisition failure rates of 1% and 10% for non-dense and dense cataracts, respectively, and the IOLMaster^ 500 had corresponding failure rates of 5% and 26%. Consistent with the full population, mean measurement time with ARGOS® was about 57 seconds in non-dense cataracts and one minute and four seconds in dense cataracts. The other biometers showed a similar general trend, but all had longer mean measurement times than ARGOS®. Because there were no cases of acquisition failure with ARGOS®, no manual A-scans were needed. Mean manual A-scan times following acquisition failure with the IOLMaster^ and LENSTAR^ biometers ranged between four minutes and twenty-one seconds and four minutes and twenty-three seconds. The unique technical benefits of the ARGOS® SS-OCT biometer include its rapid scanning speed and use of specific refractive indices of the cornea, lens, aqueous, and vitreous segments of the eye to determine axial length. In addition, ARGOS® helps address the challenge that dense cataracts typically pose for optical biometers by using wide-beam, 1060-nm wavelength light to penetrate cataracts and reliably reach the retina. Our study demonstrated real-world benefits of the ARGOS® biometer, in the form of a low risk of axial length acquisition failure and significant reduction in biometric measurement time versus comparator optical biometers. From a practice perspective, these data suggest opportunities to streamline workflow, increase patient volume, and support greater patient satisfaction with the ARGOS® SS-OCT biometer. © 2022 Alcon Inc. US-ARB-2200061