Effect Of Reusing the Operative Supplies On Cataract Surgery and Climate Change

NCT06102265 | Unknown DMC

• 1 other identifier: soh-med-23-10-06PD
• Study Type: observational
• Target: 2,000
• Locations: 1 country
• Sites: 2

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 0.02% 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 waste3,4. 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 5.9 kg of carbon emissions4. In comparison to the United Kingdom and the United States of America, the cataract surgery's low rates of infection in AECS were accomplished with 1/10 supply costs and 1/20 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

Conditions

Ophthalmopathy

Outcome Measures

Primary Outcomes (1)

• postoperative complications

  rate of occurence of infection

  6 months

Study Arms (2)

group 1

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.

Procedure: sterilization

group 2

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, 0.1 ml was injected intracamerally at the end of the operation. Finally, we did corneal hydration of the main wound and the side ports.

Procedure: sterilization

Interventions

sterilization PROCEDURE

the use of sterilization methods and the reuse of gowns

group 1; group 2

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

patients with cataract subjected to phcoemulsification

You may qualify if:

• adults with cataract not diabetics not hypertensive

You may not qualify if:

• youngs diabetics hypertensive

Sponsors & Collaborators

• Sohag University: lead

Study Sites (2)

Sohag University

Sohag, 82524, Egypt

RECRUITING

Hany Mahmoud

Sohag, Egypt

RECRUITING

MeSH Terms

Conditions

Eye Diseases

Interventions

Sterilization

Intervention Hierarchy (Ancestors)

Infection Control; Communicable Disease Control; Public Health Practice; Public Health; Environment and Public Health

Central Study Contacts

Hany Mahmoud

CONTACT

01024368111; drhanymahmoud@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 6 Months
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: ophthalmology lecturer

Study Record Dates

• First Submitted: October 22, 2023
• First Posted: October 26, 2023
• Study Start: August 1, 2023
• Primary Completion: November 1, 2023
• Study Completion: November 1, 2023
• Last Updated: October 26, 2023

Record last verified: 2023-10

Locations

EG (2)