Ignite Creation Date:
2024-05-06 @ 7:42 PM
Last Modification Date:
2024-10-26 @ 3:12 PM
Study NCT ID:
NCT06102265
Status:
RECRUITING
Last Update Posted:
2023-10-26
First Post:
2023-10-22
Brief Title:
Effect Of Reusing the Operative Supplies On Cataract Surgery and Climate Change
Sponsor:
Sohag University
Organization:
Sohag University
Study Overview
Official Title:
Effect Of Reusing the Operative Supplies On Cataract Surgery and Climate Change
Status:
RECRUITING
Status Verified Date:
2023-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Although postoperative infectious endophthalmitis and toxic anterior segment syndrome TASS rarely happen they can threaten sight and are considered complications of intraocular and cataract surgery1
Reusing surgical supplies during cataract surgery especially in developing countries will have a treble impact in lowering the financial costs of surgery the emissions of greenhouse gas and environmental waste Nearly half the waste of cataract surgery is recyclable as reported by a prospective Malaysian study 8
Despite the increasing evidence of reusing the operative supplies numerous healthcare professionals may be reluctant to consider it due to worries about cross-contamination among patients2
According to the Aravind Eye Care System AECS in Tamil Nadu India endophthalmitis rated 002 in over a million consecutive cataract cases despite the observation that cannulas irrigation aspiration tubing gowns surgical gloves irrigating bottles as well as topical and intraocular drugs are normally recycled to cut cost and waste34
On the other hand health care plays a key role in climate change as well as financial and environmental waste2 Cataracts are the leading cause of blindness and visual impairment worldwide making cataract surgery one of the most performed surgical procedures5 The carbon footprint of cataract surgery especially phacoemulsification is a significant research field6-8
In the United Kingdom cataract surgery releases 180 kg of CO2- equivalents per eye causing over half of the emissions due to obtaining large disposable medical equipment9 In ACES phacoemulsification generated 59 kg of carbon emissions4
In comparison to the United Kingdom and the United States of America the cataract surgerys low rates of infection in AECS were accomplished with 110 supply costs and 120 global warming emissions6
Being the most performed operation cataract surgery and ophthalmology in general can meaningfully influence lowering environmental and economic waste in their surgical services1
The aim of this work is to show if reusing the operative supplies to reduce financial costs especially in developing countries and to lower global warming and climate change will affect the rate of postoperative endophthalmitis after cataract surgery
Reusing surgical supplies during cataract surgery especially in developing countries will have a treble impact in lowering the financial costs of surgery the emissions of greenhouse gas and environmental waste Nearly half the waste of cataract surgery is recyclable as reported by a prospective Malaysian study 8
Despite the increasing evidence of reusing the operative supplies numerous healthcare professionals may be reluctant to consider it due to worries about cross-contamination among patients2
According to the Aravind Eye Care System AECS in Tamil Nadu India endophthalmitis rated 002 in over a million consecutive cataract cases despite the observation that cannulas irrigation aspiration tubing gowns surgical gloves irrigating bottles as well as topical and intraocular drugs are normally recycled to cut cost and waste34
On the other hand health care plays a key role in climate change as well as financial and environmental waste2 Cataracts are the leading cause of blindness and visual impairment worldwide making cataract surgery one of the most performed surgical procedures5 The carbon footprint of cataract surgery especially phacoemulsification is a significant research field6-8
In the United Kingdom cataract surgery releases 180 kg of CO2- equivalents per eye causing over half of the emissions due to obtaining large disposable medical equipment9 In ACES phacoemulsification generated 59 kg of carbon emissions4
In comparison to the United Kingdom and the United States of America the cataract surgerys low rates of infection in AECS were accomplished with 110 supply costs and 120 global warming emissions6
Being the most performed operation cataract surgery and ophthalmology in general can meaningfully influence lowering environmental and economic waste in their surgical services1
The aim of this work is to show if reusing the operative supplies to reduce financial costs especially in developing countries and to lower global warming and climate change will affect the rate of postoperative endophthalmitis after cataract surgery
Detailed Description:
Although postoperative infectious endophthalmitis and toxic anterior segment syndrome TASS rarely happen they can threaten sight and are considered complications of intraocular and cataract surgery1
Reusing surgical supplies during cataract surgery especially in developing countries will have a treble impact in lowering the financial costs of surgery the emissions of greenhouse gas and environmental waste Nearly half the waste of cataract surgery is recyclable as reported by a prospective Malaysian study 8
Despite the increasing evidence of reusing the operative supplies numerous healthcare professionals may be reluctant to consider it due to worries about cross-contamination among patients2
According to the Aravind Eye Care System AECS in Tamil Nadu India endophthalmitis rated 002 in over a million consecutive cataract cases despite the observation that cannulas irrigation aspiration tubing gowns surgical gloves irrigating bottles as well as topical and intraocular drugs are normally recycled to cut cost and waste34
On the other hand health care plays a key role in climate change as well as financial and environmental waste2 Cataracts are the leading cause of blindness and visual impairment worldwide making cataract surgery one of the most performed surgical procedures5 The carbon footprint of cataract surgery especially phacoemulsification is a significant research field6-8
In the United Kingdom cataract surgery releases 180 kg of CO2- equivalents per eye causing over half of the emissions due to obtaining large disposable medical equipment9 In ACES phacoemulsification generated 59 kg of carbon emissions4
In comparison to the United Kingdom and the United States of America the cataract surgerys low rates of infection in AECS were accomplished with 110 supply costs and 120 global warming emissions6
Being the most performed operation cataract surgery and ophthalmology in general can meaningfully influence lowering environmental and economic waste in their surgical services1
The aim of this work is to show if reusing the operative supplies to reduce financial costs especially in developing countries and to lower global warming and climate change will affect the rate of postoperative endophthalmitis after cataract surgery Preoperatively all patients underwent routine systemic examinations such as blood pressure and blood glucose level measurements ECG and hepatitis markers
No preoperative topical antibiotics prophylaxis was described for all patients Retrobulbar and peribulbar anesthesia were used for all patients While performing the anesthesia a drop of topical anesthesia a drop of povidone-iodine 5 and a drop of Moxifloxacin Vigamox were installed in the conjunctival cul-de-sac immediately prior to the surgery Topical povidone-iodine was utilized immediately prior to the surgery in order to prepare the periorbital area 10 After opening the face drape a drop of povidone-iodine 5 was also installed in the conjunctival sac and washed thoroughly before starting the operation
Topical Gatifloxacin Tymer and Prednisolone Optipreddrops were instilled four times daily in the first 10 days following the surgery Additionally a topical combination solution of Ofloxacin dexamethasone Dexaflox and a lubricantSystane was used three times daily for the next four weeks
Hand sterilization of the surgeon and the assistant was done once before starting the first case with povidone-iodine and alcohol
In one arm of the study group the surgeon changed the gown and the glove between each case with hand sterilization with alcohol before and after wearing the next glove
Each keratome and MVR were used for multiple patients until they became blunt We used the same IOL cartridge for every three cases and the same OVD in multiple patients We immersed keratome MVR IOL cartridge and cannulas of OVD in alcohol between cases
As regard the phaco machine we used Alcon Infiniti and Alcon Centurion and the same tip for all cases The tip was immersed in a test chamber filled with alcohol between cases and not changed until we noticed a morphological change or they became blunt Also the same cassette was used in multiple surgeries and changed after collecting the plastic bag full of fluid
We routinely used intracameral Moxifloxacin Vigamox as antibiotic prophylaxis The bottle of 5ml was withdrawn put in the irrigating bottle of phacoemulsification used throughout the operation and used for multiple patients until the bottle became empty
In another arm we used the same steps except that the surgeon changed the glove only and used alcohol for hand sterilization before and after wearing the next glove One gown was used for all the cases As regard the intracameral antibiotic prophylaxis a bottle of Vigamox 5ml was withdrawn and each 1 ml was diluted with 5 ml saline Using this dilution 01 ml was injected intracamerally at the end of the operation Finally we did corneal hydration of the main wound and the side ports
Reusing surgical supplies during cataract surgery especially in developing countries will have a treble impact in lowering the financial costs of surgery the emissions of greenhouse gas and environmental waste Nearly half the waste of cataract surgery is recyclable as reported by a prospective Malaysian study 8
Despite the increasing evidence of reusing the operative supplies numerous healthcare professionals may be reluctant to consider it due to worries about cross-contamination among patients2
According to the Aravind Eye Care System AECS in Tamil Nadu India endophthalmitis rated 002 in over a million consecutive cataract cases despite the observation that cannulas irrigation aspiration tubing gowns surgical gloves irrigating bottles as well as topical and intraocular drugs are normally recycled to cut cost and waste34
On the other hand health care plays a key role in climate change as well as financial and environmental waste2 Cataracts are the leading cause of blindness and visual impairment worldwide making cataract surgery one of the most performed surgical procedures5 The carbon footprint of cataract surgery especially phacoemulsification is a significant research field6-8
In the United Kingdom cataract surgery releases 180 kg of CO2- equivalents per eye causing over half of the emissions due to obtaining large disposable medical equipment9 In ACES phacoemulsification generated 59 kg of carbon emissions4
In comparison to the United Kingdom and the United States of America the cataract surgerys low rates of infection in AECS were accomplished with 110 supply costs and 120 global warming emissions6
Being the most performed operation cataract surgery and ophthalmology in general can meaningfully influence lowering environmental and economic waste in their surgical services1
The aim of this work is to show if reusing the operative supplies to reduce financial costs especially in developing countries and to lower global warming and climate change will affect the rate of postoperative endophthalmitis after cataract surgery Preoperatively all patients underwent routine systemic examinations such as blood pressure and blood glucose level measurements ECG and hepatitis markers
No preoperative topical antibiotics prophylaxis was described for all patients Retrobulbar and peribulbar anesthesia were used for all patients While performing the anesthesia a drop of topical anesthesia a drop of povidone-iodine 5 and a drop of Moxifloxacin Vigamox were installed in the conjunctival cul-de-sac immediately prior to the surgery Topical povidone-iodine was utilized immediately prior to the surgery in order to prepare the periorbital area 10 After opening the face drape a drop of povidone-iodine 5 was also installed in the conjunctival sac and washed thoroughly before starting the operation
Topical Gatifloxacin Tymer and Prednisolone Optipreddrops were instilled four times daily in the first 10 days following the surgery Additionally a topical combination solution of Ofloxacin dexamethasone Dexaflox and a lubricantSystane was used three times daily for the next four weeks
Hand sterilization of the surgeon and the assistant was done once before starting the first case with povidone-iodine and alcohol
In one arm of the study group the surgeon changed the gown and the glove between each case with hand sterilization with alcohol before and after wearing the next glove
Each keratome and MVR were used for multiple patients until they became blunt We used the same IOL cartridge for every three cases and the same OVD in multiple patients We immersed keratome MVR IOL cartridge and cannulas of OVD in alcohol between cases
As regard the phaco machine we used Alcon Infiniti and Alcon Centurion and the same tip for all cases The tip was immersed in a test chamber filled with alcohol between cases and not changed until we noticed a morphological change or they became blunt Also the same cassette was used in multiple surgeries and changed after collecting the plastic bag full of fluid
We routinely used intracameral Moxifloxacin Vigamox as antibiotic prophylaxis The bottle of 5ml was withdrawn put in the irrigating bottle of phacoemulsification used throughout the operation and used for multiple patients until the bottle became empty
In another arm we used the same steps except that the surgeon changed the glove only and used alcohol for hand sterilization before and after wearing the next glove One gown was used for all the cases As regard the intracameral antibiotic prophylaxis a bottle of Vigamox 5ml was withdrawn and each 1 ml was diluted with 5 ml saline Using this dilution 01 ml was injected intracamerally at the end of the operation Finally we did corneal hydration of the main wound and the side ports
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None