Related Experiment Video
Updated: Jul 16, 2025

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Paper waste from instructions for use brochures in cataract surgery implant packaging in Europe and the United States
Benjamin Stern1, Radhika Rampat, David Shahnazaryan
1From the Anterior Segment and Refractive Surgery Department, Rothschild Foundation Hospital, Paris, France (Stern, Gatinel); Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel (Stern); Department of Ophthalmology, Royal Free London NHS Foundation Trust, London, United Kingdom (Rampat); Centre for Sight, London, United Kingdom (Shahnazaryan).
Purpose:
To assess the extent of paper waste generated per year by instructions for use (IFUs) brochures included in intraocular lens (IOL) packaging in Europe and the U.S.
Setting:
Rothschild Foundation Hospital, Paris, France; Royal Free London NHS Foundation Trust; Center for Sight, London, United Kingdom.
Design:
Experimental study.
Methods:
A sample of IOLs were collected and each IFU was weighed. In addition, the cumulative weight of these brochures used in cataract surgeries performed annually in Europe and the U.S. was estimated, and the potential annual paper conservation that could be achieved if all manufacturers adopted electronic IFUs (e-IFUs) in Europe and the U.S. was determined.
Results:
The mean and standard deviation of the weight for overall IFUs, classic IFUs, and e-IFUs were 17.6 ± 13.8 g, 23.5 ± 13.2 g, and 2.9 ± 1.9 g, respectively. The estimated cumulative weight of paper generated from the IFUs accompanying implants used in European and U.S. cataract surgeries is 153 tons. If all manufacturers transition to e-IFUs, the cumulative weight saved would be 128 tons (-84%), equivalent to 120 tons of carbon dioxide equivalent and the preservation of more than 2000 trees annually.
Conclusions:
The classic IFUs in IOL packaging result in a significant amount of paper waste annually. Therefore, there is an urgent need for a rapid transition to e-IFU technology. The adoption of e-IFUs has already been authorized in Europe and the U.S., and it is crucial to expedite this process.
More Related Videos
04:59Author Spotlight: Enhancing Visual Outcomes in Cataract Surgery: A Novel Technique to Prevent Posterior Capsular Opacification Through IOL Rotation
Published on: July 7, 2023
08:40Author Spotlight: A Novel 3D-Printed Titanium Implant for Minimally Invasive Treatment of Hip Dysplasia in Young Dogs
Published on: April 19, 2024