Eyeworld

16 | EYEWORLD | SPRING 2026 ASCRS NEWS EYESUSTAIN UPDATE by Stephanie Chen, MD About the author Stephanie Chen, MD Altos Eye Physicians Los Altos, California References 1. Chen SP, et al. Quantifying the reduction in economic and environmental waste from multi-use phacoemulsification tubing/cassettes and diamond blades. J Cataract Refract Surg. 2026;52:124–130. 2. Chang DF, et al. The unmet need for multiuse phacoemulsi- fication machine products: multi- society position paper. J Cataract Refract Surg. 2026;52:117–123. emissions. Like many surgeons, we have long felt that the volume of disposable supplies used in cataract surgery is needlessly excessive. But what can be done? Regulatory restrictions and liability risk are often cited as the major barriers to broader adoption of reusable products in the U.S. Many surgical supplies are labeled "single use" not because of evidence proving the dangers of reusability but because manufacturers have not separately validated reuse for FDA approval, an expensive and time-consuming process. Current CMS regulations effectively prohibit off-label reuse, despite extensive international data demonstrating safety in high-volume settings, for example, from the Aravind Eye Care System in India. Moreover, phaco "day" cassettes, which allow the same cassette to be used for multiple consecutive procedures without reprocessing, are already commercially available in more than 60 countries, yet the U.S. is not among them. Understanding that regulatory changes take time, we conducted a study to quantify the Reducing cost, waste, and carbon emissions in cataract surgery through reusable devices continued on page 19 Cataract surgery in the U.S. currently emphasizes disposable single-use supplies, creating a system marked by increased costs, excessive waste, and a growing carbon footprint. In this EyeSustain Update column, Stephanie Chen, MD, dives into the cost and waste reduction achieved from transi- tioning to a reusable phaco platform and reusable diamond knives, from her recent study published in the Journal of Cataract & Refractive Surgery (JCRS). 1 Dr. Chen also highlights the recent multi-society position paper published in JCRS advocating for access to multiuse phaco cassettes. 2 Emily Schehlein, MD EyeSustain Update Guest Editor M uch of the environmental footprint in ophthalmology comes from operating room waste, particular- ly in cataract surgery. With more than 4 million cataract procedures performed annually in the U.S., even small changes in per-case resource use can translate into meaningful reductions in cost, waste, and Twenty single-use Johnson & Johnson Vision Signature Pro phaco tubing/cassette sets are replaced by one Compact Intuitiv multiuse cassette. Source: David F. Chang, MD

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