As a result of improvements in operational efficiencies, vitreoretinal surgery, in particular minimally invasive surgery, is gaining popularity in ambulatory surgical centers. Due to more dependable methods of single use instruments, the use of reusable medical equipment in small-gauge vitrectomy surgery is currently being reexamined.

Disposable or Single Use Instruments

It is necessary to consider whether vitreoretinal medical devices should be reusable or disposable, as well as how reliable they are, how fragile they are, how sterile they are, how much they cost, and how many devices are required.

• The challenge here is to strike a balance between limiting reuse in order to preserve both efficiency and cleanliness and delivering adequate eye care to people who are financially unable to pay for surgery. 10%–15% of patients have the financial means to pay for a vitrectomy.

• The success of cataract, retinal, and refractive surgery is directly correlated to the level of comfort experienced by the surgeon throughout the procedure. Some authors are of the opinion that medical devices designed for single use are more reliable than those designed for multiple uses.

When deciding between reusable and disposable medical devices, the following factors should be taken into consideration:

Safety:

Because they are resistant to antibiotics, bacteria require innovative ways to disinfect and sterilize surfaces. The use of medical equipment designed for a single patient ensures the highest level of protection against infection and cross-contamination throughout any procedure. The manipulation of neural tissue carries a high level of danger since prions and other infectious viruses can be found on contaminated devices.

It can be challenging to clean safely ophthalmic devices that include lumens. It is essential for the cutting edges of blades and other equipment to be sharp and precise. It is recommended that these things be changed out for medical supplies that are single-use only.

Time:

Time is yet another element that is difficult to quantify. Medical equipment that is sanitary and only used once can save patients time and keep them from having to reschedule their treatments because they have lost or broken other devices. Cleaning and sterilizing reusable microsurgical equipment is a more time-consuming process. A delay in a case that may or may not be significant can be caused by the need to replace an instrument.

Reliability:

The precision of membrane removal or cutting can be compromised by the use of reusable forceps or scissors over time, which can cause delays and complications during surgical procedures.

Fragility:

Reusable medical equipment needs periodic maintenance and replacement. The care and use of these medical devices by ophthalmic surgery personnel determine how long they will last.

As vitreoretinal surgery grew less common, the maintenance and cleaning of reusable microsurgical medical tools (23 g/ 25 g) became more difficult. A surgical procedure can be slowed down significantly by even the tiniest modification to the grasping platform or the scissor blades.

Economical:

Pricing reusable medical equipment can be more difficult. It is more expensive to purchase, store, and replace medical equipment that is designed for single-patient usage. Think about how much more it will cost. The fact that surgeons require multiples of each tool drives up the price of brand-new apparatus. 2 The cost of repairing and maintaining these larger medical devices is far lower than that of smaller-gauge surgical equipment. For instance, gathering, packing and transporting equipment to a sterilizing facility after each surgery involves manpower and transportation. This is because the equipment needs to be sterilized. It is important to remember to factor in the cost of replacing any instruments that are broken or lost when cleaning.

Properties

Single use medical devices have outstanding mechanical capabilities and quality due to their unique composition.

Ecological:

There is a possibility that single-use medical devices are better for the environment than reusable medical devices because they do not require the same level of disinfection chemicals, shipping, or energy to be reprocessed. In accordance with the National and European Clinical Waste Regulations, single use surgical medical equipment is considered clinical waste and must be disposed of in accordance with these regulations.

This typically involves incineration or disposal in landfills, which raises environmental concerns. For more, Check: Surgical Instruments.