JCRS Highlights

Cataract surgeons must do their part in reducing waste and pollution

September’s issue of JCRS focused on the role cataract surgeons can play in reducing greenhouse gases and plastic waste. In his editorial, Thomas Kohnen noted that if the healthcare industry were a country, it would be the fifth largest greenhouse gas emitter on the planet. Since cataract surgery is one of the most common surgical procedures performed worldwide, it contributes considerably to healthcare’s environmental footprint. However, there are steps that every medical facility can take to identify and implement ways to reduce waste and carbon emissions in cataract surgery. On an international scope, ESCRS President Oliver Findl announced Mission Zero, an ESCRS commitment to hold the 2023 ESCRS Congress with zero waste to landfills and zero net carbon emissions. The ESCRS Executive Board already took steps towards this goal in planning the 2022 ESCRS Congress in Milan, Italy.

T Kohnen, “Becoming more eye-ficient,” 48(9): 983–984.

Wide consensus among ophthalmic societies for reuse of multidose containers

The issue features a position article on the Ophthalmic Instrument Cleaning and Sterilization (OICS) Task Force’s efforts to reduce topical drug waste with ophthalmic surgery. The Task Force includes representatives of the ASCRS, the AAO, the AGS, and the OOSS. They made three principal recommendations: 1) If proper guidelines are followed, topical drugs in multidose containers can be used on multiple patients in surgical facilities; 2) Topical drugs in multidose containers can be used until the manufacturer’s labelled date of expiration; and, 3) When applicable, patients should be able to bring their partially used medication home for postoperative use. In support of the recommendations, the Task Force cited studies showing that when proper guidelines were followed, reuse of eye medication bottles on multiple patients did not contribute to increased endophthalmitis rates. In addition, they point out using topical medications until their expiration date complies with CDC infection control guidelines. The American Medical Association House of Delegates unanimously adopted a resolution to permit the dispensing of stock medications for post-discharge use and the safe use of multidose eyedrops on multiple patients, which several ophthalmological societies have subsequently endorsed.

D Palmer et al., “Reducing topical drug waste in ophthalmic surgery: multisociety position paper”, 48(9): 1073–1077.

More than hospital outpatient departments

A survey of more than one thousand ophthalmologists conducted in 2019 by the OICS Task Force showed that although most would be willing to reuse surgical devices, supplies, and pharmaceuticals to combat wasteful practices, few were actually doing so. A further review of the survey data shows surgeons operating in ambulatory surgery centres (ASCs) were more likely to have adopted waste reduction policies than those working in hospital outpatient departments (HOPDs).

C L Thiel et al., “Differences in reuse of cataract surgical supplies and pharmaceuticals based on type of surgical facility”, 48(9): 1092–1094.