Real-World Strategies for New Tech Adoption

Successful implementation of new technology in the operating theatre requires preset goals, teamwork, and communication with manufacturers, advised Norbert Pesztenlehrer MD.

Dr Pesztenlehrer speaks from experience, having introduced many digital technologies into his hospital in Győr, a Hungarian city between Budapest and Vienna. He has collected objective and subjective data on the transition from the standard manual to a completely digital OR.

With more than ten thousand toric IOLs implanted since 2012, he decided to implement digital marking in 2015, first adopting the Verion system (Alcon) before implementing a 3D visualisation system to accommodate a hernia caused by bad posture. He then added an SS-OCT biometry system in 2019 and has begun using the ESCRS online calculator to increase precision.

Better visual quality must be the main destination, he said, emphasising the Hippocratic oath of improving patient health above all else. For this reason, everything must focus on improving surgical performance, step by step. Implementing technology for this purpose requires an easy-to-learn workflow, with reliable features like proper device interconnectivity that may reduce the rate of error—human and software alike.

As Dr Pesztenlehrer experienced, this is not an easy task for the producer. New technology must comply with all sorts of regulations—the privacy and security issues requested by the European guidelines and all the national and local regulations. While this is a problem of the manufacturer, it is something surgeons must navigate.

Dr Pesztenlehrer further explained implementing digital technology into a professional practice is now thoroughly guided by companies, from practice to organisation up to control and confirmation of changes. However, he stressed it is important to change one or two variables in the process, check the results, keep track of the processes, and optimise workflow.

During the presentation, he highlighted how much space an open platform can leave for optimisation, especially with the extremely reliable software manufacturers provide. He observed there is always room for collaboration with the company to develop a simpler, faster, and more reliable method, with the addition of a seamless integration of many systems. As a surgeon, he admitted he and colleagues are not dealing with an electric car “that you get in and push a pedal,” but with something that requires regular training and self-improvement.

The change is a digital revolution that may find some resistance among baby boomers and Gen X, but high acceptance among millennials and Gen Z, he said.

To further support the benefits of this implementation, Dr Pesztenlehrer showed some data from his surgical experience. Starting with the manual implantation of the 2013–2015 period, mean postoperative astigmatism was between 0.48 and 0.39 D. With the implementation of digital marking, Barrett formulas, a 3D system, and an SS-OCT, the average gradually lowered to 0.07 D of cylinder.

The implementation of 3D and SS-OCT showed the same positive trend of subjective data. There is a constant improvement, he observed.

Finally, for success with new technology, he stressed having a motivated team—adding pivotal technological support from the manufacturers can trigger that enthusiasm, setting the course for further development and innovation.

Dr Pesztenlehrer spoke in a session on new technology at the 2024 ESCRS Congress in Barcelona.

Norbert Pesztenlehrer MD is Head of Ophthalmology at Petz County Hospital, Győr, Hungary. pesztenlehrern@gmail.com