Estimation of the Economic and Environmental Impact of Single-Use Instruments in Routine Cataract Surgery

Vincent Qin,1,2 Ben LaHood,3 Ivo Guber,4 Sandro Di Simplicio Cherubini5 1Department of Ophthalmology, Delta Hospital (CHIREC), Brussels, Belgium; 2Department of Ophthalmology, Centre Medical du Val, Brussels, Belgium; 3Department of Ophthalmology, The Queen Elizabeth Hospital, Adelaïde, Australia; 4Department of Ophthalmology, University of Geneva, Geneva, Switzerland; 5The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UKCorrespondence: Vincent Qin, Centre Medical du Val, 18 rue Edouard Gersis, 1150 Woluwe Saint Pierre, Brussels, Belgium, Email [email protected]: To estimate the economic and environmental impact of single-use instruments (SUIs) to perform standard cataract surgery in six ophthalmology centers located in Europe and in the United States.Setting: Online survey and interview.Design: Comparative cost analysis based on an online survey with follow-up questionnaire and interview. The carbon footprint calculation was made by ClimatePartner.Methods: Annual costs of reusable instruments (RUIs) were calculated based on data provided by the centers. Annual costs of SUIs were estimated based on the average-selling price of a single-use cataract set of 5 instruments and the reported annual volume of cataract surgery. The calculation carbon footprint of a cataract instrument covered the whole life cycle from production to end-of-life.Results: Annual costs for SUIs were found inferior or similar to the annual costs for RUIs for 4 out of the 6 centers included in this study. The centers where SUIs were demonstrated to be the most cost-effective were also associated with the highest costs of sterilization per instrument. The carbon footprint of 5-years usage of a cataract instrument was found to be 5478.2 kg CO2 eq for SUIs without recycling, 4639.9 kg CO2 eq for SUIs with recycling and 20.6 kg CO2 eq for RUIs.Conclusion: The study demonstrated that SUIs can be an alternative solution to using RUIs in multispecialty hospitals associated with high sterilization costs.Keywords: cost analysis, cataract surgery, surgical instruments, reusable instruments, single-use instruments, environmental impact, carbon footprint