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Archive February 2020 XXI, No. 2

Should You Switch to Disposable Cataract Supplies?

Cost, safety and environmental impact all play a role, but surgeon preference is still paramount.

Jared Bilski

BIO

ONE AND DONE
Pamela Bevelhymer, RN, BSN, CNOR
ONE AND DONE Disposable instruments eliminate reprocessing concerns and therefore might be the safest option.

From steel blades to iris hooks and pupil expanders to cannulas and phaco tubing, you can get virtually any of the instrumentation your facility needs to perform cataract surgeries in disposable form. But should you? We asked three experts about what factors to consider when it comes to determining whether to sink money into single-use options.

Surgeon preference

In many situations, the disposable versus reusable debate comes down to two things: The surgeon's personal preference and comfort level with the instrument. This is especially true for ophthalmic blades.

"I like a non-disposable diamond blade because it's the sharpest instrumentation available," says T. Hunter Newsom, MD, a cataract and refractive surgeon and the founder of the Newsom Eye & Laser Center in Sebring and Tampa, Fla. But Dr. Newsom is the outlier in his own practice, where the other surgeons all prefer to use disposable knives.

"They like that the disposable steel blades aren't quite as sharp, so they're more forgiving," says Dr. Newsom. "You can lean a little to the right and it's not going to extend the incision. You can't do that with the diamond blade. You have to go straight in, and straight out."

Durability is an important consideration to keep in mind when deciding between reusable vs. disposable products. Consider the example of iris expansion devices, which cost around $50 for single-use options and $125 to $150 for multi-use versions. If you can use the reusable ones five, six or seven times, your cost per case drops down to $20 to $30, which is less than the cost of the disposable model. But here's where it's critical for surgical facility leaders to understand the skills of their surgeons. "If you have a surgeon who's taking what's supposed to be a multi-use device and consistently getting just one use out of it [due to damage], you're probably going to need to invest in disposables," says Dr. Newsom.

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