Chemical and physical analysis of phaco handpiece tip surfaces before and after cataract surgery

Cecchini, Paolo; D’Aloisio, Rossella; Antonuccio, Manlio; Turco, Gianluca; Bondino, Federica; Magnano, Elena; Nicola, Marta Di; Tognetto, Daniele

doi:10.1016/j.jcrs.2017.05.027

Cited by 10 publications

(6 citation statements)

References 19 publications

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“…The reuse of cataract surgery instruments that might otherwise be sold as single-use, such as the phacoemulsification cassette and probe tips, has received much attention. 56,[116][117][118] After repeated experimental use on porcine eyes, there were no detectable ultrastructural changes to phacoemulsification tips (whether single-use or reusable designs). 119 Disposable cassettes can contribute 8.5% of cataract surgery waste in some settings, 56 but now some manufacturers design cassettes for reuse to some extent.…”

Section: Reusementioning

confidence: 99%

“…119 Disposable cassettes can contribute 8.5% of cataract surgery waste in some settings, 56 but now some manufacturers design cassettes for reuse to some extent. 118,119 Pairing preloaded IOL delivery systems with reusable injectors is another example of more environmentally friendly product design and packaging which would generate less plastic waste. 32,56 Aravind Eye Care System reuses surgical gowns, gloves, phacoemulsification tips, blades, irrigation tubing and medications, reducing waste and emissions.…”

Section: Reusementioning

confidence: 99%

“…The reuse of cataract surgery instruments that might otherwise be sold as single‐use, such as the phacoemulsification cassette and probe tips, has received much attention 56,116–118 . After repeated experimental use on porcine eyes, there were no detectable ultrastructural changes to phacoemulsification tips (whether single‐use or reusable designs) 119 .…”

Section: Making Changes To Practicementioning

confidence: 99%

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Tracing the barriers to decarbonising ophthalmology: A review

Lam,

Bradbrook,

Gale

2024

Clinical Exper Ophthalmology

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As climate change demands increasingly urgent mitigation of greenhouse gas emissions, the health sector needs to do its part to decarbonise. Ophthalmologists share concerns about climate change and seek opportunities to reduce their environmental impact. When measuring the footprint of ophthalmology, major contributions are from patient travel to clinics, and from the large amounts of single‐use disposable materials that are consumed during surgeries and sterile procedures. Ophthalmic services in India have already demonstrated systems that consume far fewer of these products through efficient throughput of patients and the safe reuse of many items, while maintaining equivalent safety and quality outcomes. Choosing these low‐cost low‐emission options would seem obvious, but many ophthalmologists experience barriers that prevent them operating as Indian surgeons do. Understanding these barriers to change is a crucial step in the decarbonisation of ophthalmology and the health sector more broadly.

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Section: Reusementioning

confidence: 99%

Section: Reusementioning

confidence: 99%

Section: Making Changes To Practicementioning

confidence: 99%

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Tracing the barriers to decarbonising ophthalmology: A review

Lam,

Bradbrook,

Gale

2024

Clinical Exper Ophthalmology

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“…24 Surgical packs that include single-use equipment-specific surgical supplies can potentially improve patient safety if the alternative is reusing single-use devices to address budget and supply shortage concerns, as has been demonstrated in a study of phaco handpiece tips used in cataract surgery. 25 Although not assessed in our model, full utilization of comprehensive Custom-Pak could potentially improve the quality of ophthalmological surgeries by reducing contamination of supplies versus use of generic commodity packs requiring the handling of additional individual supplies with varying levels of sterility; 5 potential reduction of waste and time spent on waste management could be additional benefits.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Custom-Pak® in Cataract and Vitreoretinal Surgery in Canadian Hospitals: Time and Budget Impact Analysis

Punch¹,

Davis²,

Hahn³

et al. 2023

CEOR

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Purpose Surgical procedure packs are commonly used in ophthalmological surgeries, but quantitative evidence demonstrating the time efficiency and economic impact of their use is limited. Evaluating the time and cost of surgical pack use is particularly important for publicly funded healthcare systems with tight budgets and/or an emphasis on value-based care. This study sought to estimate the economic impact of comprehensive surgical pack use in cataract and vitreoretinal (retina) surgeries across operating room (OR), materials management, and accounting departments in Canada. Methods A budget impact model developed for the United States (US) from a self-reported cross-sectional study was adapted for Canada. The US study obtained data via an online survey and timing exercises of surgical procedures. The model was adapted using relevant Canadian-specific labor and cost inputs. Use of generic commodity packs (no proprietary equipment-specific supplies) was compared to full utilization of Custom-Pak ® , a comprehensive pack (disposables plus equipment-specific supplies) in cataract and retina surgeries at the facility and aggregate group (provincewide) levels. Results Switching from generic to comprehensive pack use in all 2500 cataract procedures at a community hospital saves 287 labor hours per year, primarily in the materials management department. Surgery preparation (OR) hours saved allow for an additional 196 potential procedures annually. Most of the Canadian Dollar (CAD) $39,815 annual cost savings are realized for the OR. Aggregating across 50,000 cataract surgeries at the provincial level yields savings of 5608 hours and 3916 additional procedures, translating to hidden cost reductions of CAD$790,632 annually. Implementing full Custom-Pak use at the facility level in 1000 retina cases saves $10,650 annually; provincewide, 127 potential additional procedures can be gained. Conclusion Comprehensive Custom-Pak use improves efficiency in cataract and retina surgeries saving substantial time and cost in Canadian hospitals, potentially allowing more patients to have these procedures, and reducing wait times.

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“…The stylus vertical movement on the specimens’ surfaces is converted into an electrical signal by an inductive gauge. This profilometer has shown a high resolution and a high accuracy [ 7 , 8 ]. For the analysis of the raw profiles, the IOLs were positioned on a micrometric moving platform, driven at a pre-defined scanning speed and spatial resolution.…”

Section: Methodsmentioning

confidence: 99%

Profile of a new extended range-of-vision IOL: a laboratory study

Tognetto

Giglio

Giacinto

et al. 2021

Graefes Arch Clin Exp Ophthalmol

Self Cite

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Purpose To evaluate the surface profile of a new-generation extended range-of-vision intraocular lens (IOL) and to compare it with that obtained for a monofocal IOL based on the same platform. Methods Prospective, experimental, laboratory study comparing the surface profile of the DFT015 (AcrySof IQ Vivity; Alcon Laboratories, Inc.), a new-generation presbyopia-correcting IOL, with the profile of the SN60WF (AcrySof IQ; Alcon Laboratories, Inc.), an aspheric monofocal IOL based on the same platform. Raw profiles were obtained using contact profilometry. The best-fit form was then subtracted from each raw profile to highlight potential differences. Results No significant differences were appreciated in raw profiles. On the contrary, after form removal, the new extended range-of-vision IOL showed a peculiar profile characterized by the presence of two altitudinal symmetrical changes in the order of 1 µm, localized in the central portion of the optic. Conclusions The new-generation extended range-of-vision IOL evaluated showed a smooth change of its surface compared to the same platform monofocal IOL. The altitudinal changes blended in the central design of the new presbyopia-correcting IOL, although micrometric, might play a crucial role in creating a continuous focal range while minimizing visual disturbances.

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Chemical and physical analysis of phaco handpiece tip surfaces before and after cataract surgery

Abstract: Used phaco tips showed relevant signs of deterioration and deposition of biological material, mostly involving the cutting edge. Reusable tips might release remnants of previous procedures. The adoption of single-use disposable phaco tips seems to be highly advisable.

Cited by 10 publications

References 19 publications

Tracing the barriers to decarbonising ophthalmology: A review

Tracing the barriers to decarbonising ophthalmology: A review

Comprehensive Custom-Pak® in Cataract and Vitreoretinal Surgery in Canadian Hospitals: Time and Budget Impact Analysis

Profile of a new extended range-of-vision IOL: a laboratory study

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