Elimination of Post-Operative Complications in Penetrating Keratoplasty by Deploying Six Sigma
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Date
2014Author
Sahbaz, Ibrahim
Taner, Mehmet Tolga
Sahandar, Uzeyir Tolga
Erbas, Engin
Erbas, Engin
Kagan, Gamze
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This paper shows how a public eye and research hospital in Turkey initiated Six Sigma principles
to reduce the number of complications occurring after penetrating keratoplasty surgeries. Data
were collected for nine years. To analyse the complications among 55 patients (59 eyes) underwent
penetrative keratoplasty, main tools of Six Sigma’s Define-Measure-Analyze-Improve-Control
(DMAIC) improvement cycle such as SIPOC table and Failure, Mode and Effect Analysis (FMEA)
were implemented. Sources and root causes of eleven types of complications were identified and
reported. For a successful penetrating keratoplasty surgery patient’s anatomy, suitability of donor
cornea, experience of ophthalmic surgeon, sterilization and hygiene, and performance of the
equipment were determined to be the “critical-to-quality” factors. The complication with the
highest hazard score was found to be the glaucoma. The process sigma level of the process was
measured to be 3.1418. The surgical team concluded that all types of post-operative complications
should be significantly reduced by taking the necessary preventive measures.