Skip to main content

Advertisement

SpringerLink
Log in

An investigation on the current patterns of using consumables and sterilizing accessories in phacoemulsification in China

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To survey the routine application of consumables and sterilized accessories of phacoemulsification in mainland China.

Methods

This was a cross-sectional questionnaire-based study. A questionnaire link was sent to Chinese ophthalmologists via the most widely used social communication tool (WeChat platform).

Results

A total of 815 questionnaires were determined to be valid and were included in the final analysis. The majority of respondents were from Guangdong, Shandong, Zhejiang, Hebei, and Henan provinces. A number of hospitals (48.22%) reused the fluidics management system (FMS) after sterilization. Among the hospitals using disposable FMS, 38.03% reused tubing after sterilization. Most respondents’ hospitals (70.43%) sterilized the handpiece for each operation. Only 38.77% of the respondents’ hospitals adopted irrigation fluid antibiotics and/or intracameral antibiotics intraoperatively. Greater single usage of FMS was significantly associated with higher provincial gross domestic product (GDP), government hospitals, provincial hospitals, and disposable tubing (P < 0.05). The adoption of irrigation fluid/intracameral antibiotics was correlated with the financial type of the hospital, the daily volume of phacoemulsification, and the usage of silicone tubing (P < 0.05).

Conclusions

The results show a wide variation in the application of consumables and the sterilization of accessories in phacoemulsification in mainland China. Only half of the hospitals adopted interfusion/intracameral antibiotic prophylaxis, despite its efficacy having been confirmed. These data revealed potential safety issues of the sterilization of phacoemulsification instruments and the risk of intraocular infection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Liu YC, Wilkins M, Kim T, Malyugin B, Mehta JS (2017) Cataracts. Lancet 390:600–612. https://doi.org/10.1016/s0140-6736(17)30544-5

    Article  PubMed  Google Scholar 

  2. Creuzot-Garcher C, Benzenine E, Mariet AS, de Lazzer A, Chiquet C, Bron AM, Quantin C (2016) Incidence of acute postoperative endophthalmitis after cataract surgery: a nationwide study in France from 2005 to 2014. Ophthalmology 123:1414–1420. https://doi.org/10.1016/j.ophtha.2016.02.019

    Article  PubMed  Google Scholar 

  3. Jabbarvand M, Hashemian H, Khodaparast M, Jouhari M, Tabatabaei A, Rezaei S (2016) Endophthalmitis occurring after cataract surgery: outcomes of more than 480 000 cataract surgeries, epidemiologic features, and risk factors. Ophthalmology 123:295–301. https://doi.org/10.1016/j.ophtha.2015.08.023

    Article  PubMed  Google Scholar 

  4. Gower EW, Keay LJ, Stare DE, Arora P, Cassard SD, Behrens A, Tielsch JM, Schein OD (2015) Characteristics of endophthalmitis after cataract surgery in the United States medicare population. Ophthalmology 122:1625–1632. https://doi.org/10.1016/j.ophtha.2015.04.036

    Article  PubMed  PubMed Central  Google Scholar 

  5. Javitt JC (2016) Intracameral antibiotics reduce the risk of endophthalmitis after cataract surgery: does the preponderance of the evidence mandate a global change in practice? Ophthalmology 123:226–231. https://doi.org/10.1016/j.ophtha.2015.12.011

    Article  PubMed  Google Scholar 

  6. Herrinton LJ, Shorstein NH, Paschal JF, Liu L, Contreras R, Winthrop KL, Chang WJ, Melles RB, Fong DS (2016) Comparative effectiveness of antibiotic prophylaxis in cataract surgery. Ophthalmology 123:287–294. https://doi.org/10.1016/j.ophtha.2015.08.039

    Article  PubMed  Google Scholar 

  7. Chang DF, Braga-Mele R, Henderson BA, Mamalis N, Vasavada A (2015) Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: results of the 2014 ASCRS member survey. J Cataract Refract Surg 41:1300–1305. https://doi.org/10.1016/j.jcrs.2015.01.014

    Article  PubMed  Google Scholar 

  8. Grzybowski A, Schwartz SG, Matsuura K, Ong TS, Arshinoff S, Ng JQ, Meyer JJ, Liu W, Jacob S, Packer M, Lutfiamida R, Tahija S, Roux P, Malyugin B, Urrets-Zavalia JA, Crim N, Esposito E, Daponte P, Pellegrino F, Graue-Hernandez EO, Jimenez-Corona A, Valdez-Garcia JE, Hernandez-Camarena JC, Relhan N, Flynn HW, Ravindran RD, Behnding A (2017) Endophthalmitis prophylaxis in cataract surgery: overview of current practice patterns around the world. Curr Pharm Des 23:565–573. https://doi.org/10.2174/1381612822666161216122230

    Article  CAS  PubMed  Google Scholar 

  9. Gordon-Bennett P, Karas A, Flanagan D, Stephenson C, Hingorani M (2008) A survey of measures used for the prevention of postoperative endophthalmitis after cataract surgery in the United Kingdom. Eye 22:620–627. https://doi.org/10.1038/sj.eye.6702675

    Article  CAS  PubMed  Google Scholar 

  10. Zhu Y, Chen X, Chen P, Wu J, Hua H, Yao K (2017) The occurrence rate of acute-onset postoperative endophthalmitis after cataract surgery in Chinese small—and medium-scale departments of ophthalmology. Sci Rep 7:40776. https://doi.org/10.1038/srep40776

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Yao K, Zhu Y, Zhu Z, Wu J, Liu Y, Lu Y, Hao Y, Bao Y, Ye J, Huang Y, Li Z, Shentu X, Yu Y (2013) The incidence of postoperative endophthalmitis after cataract surgery in China: a multicenter investigation of 2006–2011. Br J Ophthalmol 97:1312–1317. https://doi.org/10.1136/bjophthalmol-2013-303282

    Article  PubMed  Google Scholar 

  12. Wang W, Yan W, Muller A, He M (2017) A global view on output and outcomes of cataract surgery with national indices of socioeconomic development. Invest Ophthalmol Vis Sci 58:3669–3676. https://doi.org/10.1167/iovs.17-21489

    Article  PubMed  Google Scholar 

  13. He M, Wang W, Huang W (2017) Variations and trends in health burden of visual impairment due to cataract: a global analysis. Invest Ophthalmol Vis Sci 58:4299–4306. https://doi.org/10.1167/iovs.17-21459

    Article  PubMed  Google Scholar 

  14. Wang W, Yan W, Fotis K, Prasad NM, Lansingh VC, Taylor HR, Finger RP, Facciolo D, He M (2016) Cataract surgical rate and socioeconomics: a global study. Invest Ophthalmol Vis Sci 57:5872–5881. https://doi.org/10.1167/iovs.16-19894

    Article  PubMed  Google Scholar 

  15. Coelho RP, Garcia TV, Paula JS, Cruz AA, Rocha EM, Figueiredo LT, Rodrigues ML (2012) Viral contamination during sequential phacoemulsification surgeries in an experimental model. Arq Bras Oftalmol 3:174–177. https://doi.org/10.1590/s0004-27492012000300005

    Article  Google Scholar 

  16. Leslie T, Aitken DA, Barrie T, Kirkness CM (2003) Residual debris as a potential cause of postphacoemulsification endophthalmitis. Eye 4:506–512. https://doi.org/10.1038/sj.eye.6700404

    Article  Google Scholar 

  17. Perry EC (1996) To reuse or not reuse: reuse of phacoemulsification needle tips, their efficacy, and patient response. Insight 2:45–48. https://doi.org/10.1016/s1060-135x(96)90057-3

    Article  Google Scholar 

  18. Gentile RC, Shukla S, Shah M, Ritterband DC, Engelbert M, Davis A, Hu DN (2014) Microbiological spectrum and antibiotic sensitivity in endophthalmitis: a 25-year review. Ophthalmology 121:1634–1642. https://doi.org/10.1016/j.ophtha.2014.02.001

    Article  PubMed  Google Scholar 

  19. Storey P, Dollin M, Pitcher J, Reddy S, Vojtko J, Vander J, Hsu J, Garg SJ (2014) The role of topical antibiotic prophylaxis to prevent endophthalmitis after intravitreal injection. Ophthalmology 121:283–289. https://doi.org/10.1016/j.ophtha.2013.08.037

    Article  PubMed  Google Scholar 

  20. Srinivasan R, Gupta A, Kaliaperumal S, Babu RK, Thimmarayan SK, Belgode HN (2008) Efficacy of intraoperative vancomycin in irrigating solutions on aqueous contamination during phacoemulsification. Indian J Ophthalmol 56:399–402

    Article  Google Scholar 

  21. Barry P, Seal DV, Gettinby G, Lees F, Peterson M, Revie CW (2006) ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: preliminary report of principal results from a European multicenter study. J Cataract Refract Surg 32:407–410. https://doi.org/10.1016/j.jcrs.2006.02.021

    Article  PubMed  Google Scholar 

  22. Sharifi E, Porco TC, Naseri A (2009) Cost-effectiveness analysis of intracameral cefuroxime use for prophylaxis of endophthalmitis after cataract surgery. Ophthalmology 116:1887–1896. https://doi.org/10.1016/j.ophtha.2009.03.014

    Article  PubMed  Google Scholar 

  23. Haripriya A, Chang DF, Namburar S, Smita A, Ravindran RD (2016) Efficacy of intracameral moxifloxacin endophthalmitis prophylaxis at Aravind eye hospital. Ophthalmology 123:302–308. https://doi.org/10.1016/j.ophtha.2015.09.037

    Article  PubMed  Google Scholar 

  24. Holland EJ, McDonald MB, Parekh JG, Sheppard JD (2014) Antibiotic resistance in acute postoperative endophthalmitis. Ophthalmology 121:S1–S9. https://doi.org/10.1016/j.ophtha.2014.06.049

    Article  PubMed  Google Scholar 

  25. Witkin AJ, Chang DF, Jumper JM, Charles S, Eliott D, Hoffman RS, Mamalis N, Miller KM, Wykoff CC (2017) Vancomycin-associated hemorrhagic occlusive retinal vasculitis: clinical characteristics of 36 eyes. Ophthalmology 124:583–595. https://doi.org/10.1016/j.ophtha.2016.11.042

    Article  PubMed  Google Scholar 

  26. Ding Y, Lin M, Liu H, Zhang W, Wang L, Li Y (2011) Outcomes of post-cataract surgery endophthalmitis referred to a tertiary center from local hospitals in the south of China. Infection 39:451–460. https://doi.org/10.1007/s15010-011-0138-0

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was supported by grants from the National Key Research and Development Program of China (No. 2017YFC1104603) and the National Natural Science Foundation of China (No. 81770909 and No. 81970783).

Author information

Author notes

  1. Yingyan Qin, Liangping Liu and Xiaofeng Yang contributed equally to the article.

Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China

    Yingyan Qin, Liangping Liu, Xiaofeng Yang, Wei Wang & Mingxing Wu

Authors
  1. Yingyan Qin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Liangping Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiaofeng Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mingxing Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mingxing Wu.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study was approved by the institutional research ethics committee of Zhongshan Ophthalmic Center, Sun Yat-sen University, and was conducted in accordance with the tenets of the Declaration of Helsinki.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Qin, Y., Liu, L., Yang, X. et al. An investigation on the current patterns of using consumables and sterilizing accessories in phacoemulsification in China. Int Ophthalmol 40, 3077–3085 (2020). https://doi.org/10.1007/s10792-020-01493-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-020-01493-3

Keywords

Search

Navigation