Cataract Surgery Instrumentation – Dr. James Lewis
Serving Bucks County, Philadelphia, Warminster, Montgomery County, King of Prussia, Conshohocken, Phoenixville and Delaware Valley
Ophthalmic surgeons need not only delicate instrumentation but also absolute sterility. At first, the concept of discarding ophthalmic instrumentation at the end of the surgical case sounds wasteful and non-green.
For nearly 3 decades we have routinely used disposable cannulas, syringes, and stainless steel blades with an emphasis on recycling, cost control, and patient safety. Today, several surgical instrument companies have recognized that disposable forceps, tiers, and scissors may have a place in modern surgery.
Rules for instrument sterilization in Europe changed several years ago. The US is beginning to enforce the same mandates. Standard sterilization kills all bacteria, viruses, fungi, and protozoa. Unfortunately Prions, the causative agent of Creutzfeldt–Jakob Disease (CJD), Gerstmann– Straussler–Scheinker disease, kuru, and fatal familial insomnia in addition to bovine spongiform encephalopathy (BSE, also known as Mad Cow Disease) require a full 24 hour period of instrument sterilization. That has forced surgery centers to purchase 20 to 30 “cataract trays” to comply with these new regulations.
Dr. Lewis is extremely particular about the quality and precision of his ophthalmic instrumentation. In fact, most of his cataracts patients are surprised to learn that he has converted 90 percent of his procedures to all-disposable instrumentation. Beginning with an all-disposable LASIK surgery, he also routinely performs cataract surgery with only single-use instrumentation. These instruments are biodegradable and eliminate the many toxins which result from cleaning and autoclaving. Furthermore, repair of non-disposable surgical instrumentation is a huge medical cost, and the repaired instruments never achieve the performance of new instruments.
Cost control, sterility, biodegradability, and patient safety have led to our early adoption of disposable instrumentation for LASIK, Epi-LASIK, Cataract, and Glaucoma surgery.