Reducing Ophthalmic Surgical Waste Through Electronic Instructions For Use - e-IFU

In 2021, the World Health Organization stated that climate change is the leading threat to global health and will disproportionately harm the poorest and most vulnerable communities. The global healthcare system is a major contributor to waste and accounts for 4.4% of global greenhouse gases. Cataract surgery is the most commonly performed operation in medicine with almost 30 million cases performed worldwide each year. This gives ophthalmology a unique opportunity to reduce unnecessary waste and carbon emissions.
Regulatory agencies, such as the Medical Device Regulation (MDR) in the European Union and the United States Food and Drug Administration, require manufacturers to provide detailed instructions for use or IFU, to guide proper and safe use of surgical devices and products.
In ophthalmology, IFUs accompany most routinely used devices and supplies, such as IOLs, IOL insertion cartridges, OVD, handheld bottles of saline, irrigating solution, and phacoemulsification tips and sleeves. Although some IFU may be printed on the package exterior, most are separately supplied as a printed booklet or folded handout within the product package.
In a 2013 analysis of carbon emissions from cataract surgery in the NHS, Morris et al found that over 50% of the carbon emissions arose from procurement. Within that procurement, medical equipment accounted for 32.6% and pharmaceuticals accounted for 18% of carbon emissions. Their conclusion was that GHG reduction cannot be achieved if we concentrate only on clean building energy and travel emissions – we must target the actual materials used in cataract surgery.
We recommend that surgical manufacturers replace paper IFU with an alternative, electronic-IFU whenever possible for ophthalmic surgical products.