For ophthalmic treatments to be safe and successful, reusable surgical single use instruments must be thoroughly decontaminated. Yet, because the procedure entails several steps, including collecting, cleaning, disinfection, sterilization, packaging, transportation, and storage, there is a lot of potential for instrument loss and damage. This results in additional expenses for any hospital or clinic that must frequently replace equipment that was harmed during the decontamination process. So, a creative solution to this issue is provided by single-use tools. Further replacement expenditures can be avoided while ensuring sterility by adopting a straightforward “use once and chuck away” strategy.
Why Single Use Instruments are Better:
Certain Single Use Instruments, such as those having a lumen, that is often used in ophthalmic procedures can be challenging to safely disinfect. Similar to scalpel blades, other tools require an edge that is dependably sharp and precise. As a result, these make the ideal replacements for goods that single-use instruments can be used for, and these were the ones I started with when I first started testing single-use instruments. While my clinic’s decision to test single-use equipment was primarily driven by the need to reduce the amount of money wasted each year due to broken surgical instruments, doing so has revealed several additional advantages.
For instance, each instrument’s consistently high quality and accuracy stand out in particular. The ease of usage is another obvious benefit after using single-use manipulators, forceps, and hooks for capsulorhexis. Single-use surgical instruments might seem like they would be made of inferior materials, feel substantially different during surgery, and be designed to be thrown away, but this has not been my experience. Although the quality of an instrument can vary depending on the manufacturer, I have always been impressed, especially with those made for posterior segment surgery.
The efficiency of ophthalmic surgery:
The efficiency of ophthalmic surgery should theoretically increase with the use of single use instruments. By eliminating the sterilisation procedure, significant human resources won’t need to be wasted on gathering and counting equipment or supervising the sending and receiving of instruments before and following sterilization. Unfortunately, this procedure cannot be completely avoided since, while some tools are good candidates for replacement with single-use equipment, others are not. For instance, all single-use tools are now present on my operating table, except my phacoemulsification handpiece. Also, the sterilizing procedure must continue because I still use several devices in my clinic that are multi-use. Yet, since fewer surgical instruments now need to be sterilized or replaced after becoming damaged, switching to this method has reduced costs, both financially and in terms of time.
Risks associated with tool reuse and sterilization:
The advantages of single use instruments go beyond time and financial savings. Another significant advantage is the absence of the risk of inadequate sterilization. Even though strict sterilization regulations and extensive company screening by hospitals before issuing contracts ensure that this no longer frequently occurs, the consequences can be disastrous for patients, hospitals, and surgeons. The European Commission’s newly updated Harmonised Rules for sterilization of medical devices demonstrate that preventing this is still a top priority in all surgical specialties. To meet EU regulations, the publication has been updated to include stricter guidelines for medical device sterilization.
Although these rules are intended to establish a level of service, they are guidelines rather than rigid regulations, therefore there is room for interpretational error and non-compliance. As possible, hospitals and surgeons should move to single-use tools to eliminate any confusion as legislation and standards are updated and continue to change.
Cost-effectiveness:
The topic of cost-effectiveness is almost always brought up whenever the argument between single use instruments and multi-use instruments is discussed. Is using multi-use tools always less expensive than replacing single-use ones all the time? At first glance, it would appear that purchasing a multi-use instrument would be far more expensive than purchasing single-use instruments in bulk, storing them, and constantly replacing them. However, the additional costs of multi-use instruments that are avoided by employing disposable tools must be taken into account. For instance, the expenses of sterilizing after each surgery comprise the actual costs of sterilization as well as the labor and transportation costs related to gathering, packaging, and transporting the equipment to a sterilization facility.
The cost of replacing instruments that are misplaced or broken during cleaning is another expense. In my clinic, we lost $100,000 due to sterilization equipment breakage last year, and these expenses can increase exponentially with facility size and procedure volume. Even if a tool survives sterilization undamaged, those that play a critical cutting role frequently lose some of their cutting-edge sharpness.
You gain confidence as you experiment more:
Of course, a comfortable working environment for the surgeon and top-notch equipment is essential for achieving excellent results after cataract, retinal, or refractive surgery. It’s essential to have equipment that can be relied upon to function consistently every time, and from my experience, single use instruments frequently offer more consistency than multi-use ones.
My operating table is proof that overall, I’ve had positive experiences using single-use equipment. My surgical kit originally contained just one disposable tool, but now, except for my phacoemulsification handpiece, all of the equipment is single use instruments. Single use instruments, which have advantages like large cost savings, convenience of use, and consistently good quality, I think will play a significant part in ophthalmic surgery in the future. When these tools are used more frequently, it will be interesting to see how they affect hospitals and clinics’ financial health and operational efficiency throughout Europe and the rest of the world.
