Purpose: To show how a private eye care center in Turkey initiated Six Sigma principles to reduce the number of complications encountered during and after femtosecond laser-assisted LASIK (IntraLase) surgeries. Method: Data were collected for five years. To analyse the complications among 448 surgeries, main tools of Six Sigma's Define-Measure-Analyze-Improve-Control (DMAIC) improvement cycle such as SIPOC table, Fishbone Diagram and, Failure, Mode and Effect Analysis were implemented. Sources and root causes of seventeen types of complications were identified and reported. Results: For a successful IntraLase surgery, experience of the refractive surgeon, patient's anatomy and calibration of laser power were determined to be the "critical few" factors whereas, patient's psychology, sterilization and hygiene, and suction-ring's pressure were found to be the "trivial many" factors. The most frequently occurring complication was found to be subconjunctival haemorrhage. Conclusion: The process sigma level of the process was measured to be 3.3547. The surgical team concluded that sixteen complications (out of seventeen) should be significantly reduced by taking the necessary preventive measures.

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Purpose: To show how a Turkish public eye care centre in Turkey initiated Six Sigma principles to reduce the number of complications occurring during and after pars plana vitreoretctomy surgeries. Method: Data were collected for two years. To analyse the complications among 2272 patients, main tools of Six Sigma's Define-Measure-Analyse-Improve-Control (DMAIC) improvement cycle such as SIPOC table, Fishbone Diagram and, Failure, Mode and Effect Analysis were implemented. Sources and root causes of twenty-two types of complications were identified and reported. Results: For a successful pars plana vitrectomy procedure, experience of vitreoretinal surgeon, attention of vitreoretinal surgeon, patient's anatomy were determined to be the "critical few" factors whereas, sterilization and hygiene, amount of silicone oil and amount of gas were found to be the "trivial many" factors. The most frequently occurring complication was found to be subconjunctival haemorrhage. Conclusion: The sigma level of the overall process was measured to be 3.8559. The surgical team concluded that twelve of the complications should be significantly reduced by taking the necessary preventive measures. Institutional ethics committee approval has been taken due to retrospective nature of this study.

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.

ABSTRACT:The aim of this paper is to investigate the complications which occurred in a dialysis polyclinic during and after CAPD process and evaluate them in terms of their root causes, severity, sigma levels and hazard scores. The data are collected from 24 patients over a 12-month period. Seventeen complications are determined. Six Sigma's DMAIC, SIPOC