Average Lifespan Of Reusable Instruments For Cataract Surgery

Cataract surgery remained one of the most performed surgeries worldwide and is associated with significant carbon footprint. Recent survey of the European and American cataract surgeons revealed that majority prefer reusable instruments (RUIs) over single-use instruments (SUIs) due to concerns on the environmental impact of the later. It remains unclear how frequently RUIs get replaced or repaired, rendering it difficult to calculate carbon savings for RUIs versus SUIs. Therefore the aim of this study is to evaluate the average lifespan of RUI for cataract surgery across 20 ophthalmology centres in Europe.

Ophthalmology centres providing cataract surgery in Europe.

Survey questionnaire was developed and distributed to cataract centres across Europe by the Young Ophthalmologists for Sustainability (YOFS), a working group of the European Society of Cataract and Refractive Surgeons (ESCRS). Total number of cataract surgeries across a time-span, number of phacoemulsification RUIs tray, number of RUIs replacements and repairs across the same time-span were studied. Average lifespan (number of times used before replacement) of the five most replaced RUI in each centre were calculated.

Nineteen out of 20 centres (95.0%) use a combination of RUIs and SUIs for routine cataract surgery. The five most replaced RUIs, starting from the most frequent, were capsulorrhexis forceps (average lifespan 150-3200 times), nucleus chopper (150-3730 times), adjustable lid speculum (150-4480 times), notched forceps (150-4800 times) and IOL injector (150-5500 times).

Our study demonstrated for the first time the average lifespan of RUIs for routine cataract surgery across Europe and the commonest RUIs to be replaced. The average lifespan for RUIs were potentially underestimated as most instruments were still in use and were purchased before the start of the calculated time-span, indicating further possibility for carbon saving.