Unmet need for multiuse phacoemulsification machine products: multisociety position paper

Nondegradable microplastic waste and carbon emissions from the manufacture, use, and disposal of surgical supplies pose threats to the environment and to public health. Current mandates and manufacturer labeling for single use of phacoemulsification machine supplies contribute to unnecessary waste. These practices have evolved from liability concerns over hypothetical risks. Single use of phacoemulsification supplies became the industry default in many countries partly because of stringent regulations requiring manufacturers to pursue costly studies to prove the safety of reuse. Despite this barrier, there are several approved multiuse options commercially available outside the United States. Considering the low risk of bacterial cross-contamination from cataract surgery, ophthalmologists, and surgical facilities can significantly reduce carbon emissions and nonrecyclable plastic waste by adopting multiuse phacoemulsification machine supplies. This can potentially reduce supply expenditure without financially penalizing manufacturers. Surgeons in many countries are routinely reusing single-use phacoemulsification cassettes off-label, and there is supporting evidence that this can be performed safely.