Retrospective data review shows significant reduction in cost and waste with reusable tubing and diamond knives, suggesting opportunities for sustainability in cataract surgery.
To quantify and compare the cost, waste, and carbon emissions of single-use and reusable phacoemulsification tubing/cassettes and knives. Private, single-specialty ambulatory surgery center (Mountain View, CA, USA). Retrospective data review. The cost, waste, and carbon emissions from using an approved multi-use tubing/cassette system from July 1, 2024 through June 30, 2025 were estimated and compared to those generated by single-use tubing/cassettes with the same phacoemulsification machine (Part 1). In Part 2, the cost, waste, and carbon emissions from reusable diamond knives were estimated and compared to those from using single-use metal knives for the equivalent number of cataract and other IOL-related surgeries over a 10-year period. Life-cycle equivalent analysis was performed to determine the carbon footprint of each component. For 2,700 cataract and IOL-related surgeries performed during one year, reusable cassette/tubing packs reduced cost by 66.7% ($121,500 for single-use vs. $40,500 for multi-use). For every 1,000 procedures, the reusable pack would save 322.8 kg of plastic waste and 938.3 kgCO2eq, equivalent to driving a car 2,283mi (3,674km). Over 10 years, 50,100 procedures were performed at our center. For every 1,000 procedures, using diamond knives was estimated to save $18,300 (keratomes) and $12,130 (paracentesis blades) compared to disposable metal alternatives, as well as reducing plastic waste and carbon emissions by over 99%. Cost, waste, and carbon emissions are considerably reduced by reusable phacoemulsification products, such as diamond surgical knives and multi-use phacoemulsification tubing/cassettes. This provides a major opportunity to improve the sustainability of cataract surgery.
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Chen et al. (2025) studied this question.
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