Quantifying the reduction in economic and environmental waste from multiuse phacoemulsification tubing/cassettes and...

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, California).

Retrospective data review.

The cost, waste, and carbon emissions from using an approved multiuse tubing/cassette system from July 1, 2024, through June 30, 2025, were estimated and compared with 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 with those from using single-use metal knives for the equivalent number of cataract and other intraocular lens (IOL)-related surgeries over a 10-year period. Life cycle equivalent analysis was performed to determine the carbon footprint of each component.

For 2700 cataract and IOL-related surgeries performed during 1 year, reusable cassette/tubing packs reduced cost by 66.7% ($121 500 for single-use vs $40 500 for multiuse). For every 1000 procedures, the reusable pack would save 322.8 kg of plastic waste and 938.3 kgCO 2 eq, equivalent to driving a car 2283 miles (3674 km). Over 10 years, 50 100 procedures were performed at our center. For every 1000 procedures, using diamond knives was estimated to save $18 300 (keratomes) and $12 130 (paracentesis blades) compared with disposable metal alternatives, as well as reducing plastic waste and carbon emissions by more than 99%.

Cost, waste, and carbon emissions are considerably reduced by reusable phacoemulsification products, such as diamond surgical knives and multiuse phacoemulsification tubing/cassettes. This provides a major opportunity to improve the sustainability of cataract surgery.