Disposable cataract instruments — what a country!

ByJohn A. Hovanesian, MD, FACS

When I first heard of the idea of disposable cataract instruments, my first reaction was, "WWAGD?" ("What Would Al Gore Do?") This thought passed fairly quickly, though, when I began to think about the advantages such tools had (and heard that the former veep has his own private jet and I don't).

The instruments I tried were available from Moria USA and included blades, capsulorrhexis forceps, a chopper and a Kuglen hook.

Fellow children of Depression babies: In case you're wondering if these instruments can actually be re-used, the handles are made of a plastic that will melt in an autoclave. (Drat! They thought of everything!)

While the handles are, well, molded plastic, I was pleasantly surprised by the refinement of the business end of these instruments. The tips of the capsulorrhexis forceps worked just as well as those of my treasured Storz pair. In fact, I did a whole day of surgery without really noticing much difference at all.

Some natural benefits of disposable cataract instruments are:

Speed of OR turnover - nothing to autoclave between cases;
Avoidance of risks of using an autoclave, including a failed cycle or even contaminants that can cause TASS;
The instruments come pre-sterilized in peel packs; and
Avoidance of damage to pricey instruments by Mongo the Nurse who tosses around the sledge and wedge set of Dr. Bonebreaker in that OR where you go once a month.

A number of hospitals who do small numbers of cataract procedures have already adopted these instrument sets, and a number of bigger institutions here in the U.S. (and even more in Europe) have started to as well, citing sterility as their reason.

Let us know what you think of this idea.

Editor's note: Dr. Hovanesian has no financial interests in the instruments described here.

Get more expert perspective from Dr. Hovanesian live at Hawaiian Eye 2010, to be held January 17-22, 2010 at the Grand Hyatt Kauai. Learn more at OSNHawaiianEye.com.