Quantifying the reduction in economic and environmental waste from multi-use phacoemulsification tubing/cassettes and diamond blades.

Purpose: To quantify and compare the cost, waste, and carbon emissions of single-use and reusable phacoemulsification tubing/cassettes and knives.

Setting: Private, single-specialty ambulatory surgery center (Mountain View, CA, USA).

Design: Retrospective data review.

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

Results: For 2,700 cataract and IOL-related surgeries performed during one year, reusable cassette/tubing packs reduced cost by 66.7% ($121,500 for single-use vs. $40,500 for multi-use). For every 1,000 procedures, the reusable pack would save 322.8 kg of plastic waste and 938.3 kgCO2eq, equivalent to driving a car 2,283mi (3,674km). Over 10 years, 50,100 procedures were performed at our center. For every 1,000 procedures, using diamond knives was estimated to save $18,300 (keratomes) and $12,130 (paracentesis blades) compared to disposable metal alternatives, as well as reducing plastic waste and carbon emissions by over 99%.

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