Home E-Weekly April 10, 2018

Updated Guidelines for Cleaning and Sterilizing Cataract Instruments

Published: April 10, 2018

Cataract Surgery OCULAR INSTRUMENTS Check out what's new in the latest cleaning and sterilization guidelines for cataract surgery instruments.

If your facility hosts cataract cases, you might want to get your reprocessing techs a copy of the latest cleaning and sterilization guidelines for intraocular surgical instruments.

Taking into account the unique conditions of intraocular surgery, the specialty-specific guidelines from the Ophthalmic Instrument Cleaning and Sterilization (OICS) task force outlines the minimum cleaning and sterilization standards based on a consensus of experts representing 3 sponsoring societies — the American Society of Cataract and Refractive Surgery (ASCRS), the American Academy of Ophthalmology (AAO), and the Outpatient Ophthalmic Surgery Society (OOSS).

This document is an update of original recommended practices for cleaning and sterilizing intraocular surgical instruments published in 2007. A couple of highlights:

  • Enzymatic detergents. Citing that there are no studies showing the use on enzymatic detergent reduces the rate of endophthalmitis, the new OICS guidelines state that if "intraocular surgical instruments are thoroughly rinsed with critical water promptly after each use, the routine use of enzyme detergents is unnecessary and should not be required for routine decontamination of ophthalmic intraocular instruments." Enzymatic solution that remains on intraocular instruments is a leading cause of toxic anterior segment syndrome (TASS). Studies have shown that enzymatic solution is notoriously difficult to completely rinse from instruments.
  • Short-cycle steam sterilization. Short-cycle sterilization used in accordance with the IFU of FDA-approved sterilizers are appropriate for routine use in between sequential same-day ophthalmic cases. You can't interrupt the sterilization process, but you can interrupt the drying process if the instruments are used immediately and transported appropriately. Some surveyors consider short-cycle sterilization the same as immediate-use steam sterilization, but after meeting with the task force, CMS clarified that short-cycle and IUSS are not the same.

    Recommendations for the re-use of phaco tips and ultrasonic cleaning are also included in the guidelines that were released on Friday.

    JoEllen McBride, PhD

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