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Comment on: Incidence of post vitrectomy endophthalmitis in India—a multicentric study by VRSI study Group

Eye volume 37, page 3696 (2023)Cite this article

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Thanks to the authors of the article “Incidence of endophthalmitis after vitrectomy in India—a multicentre study by the VRSI study group”, who explored through a retrospective, multicentre large study that multi-cycle reuse of disposable surgical devices is safe and effective, reduces surgical costs and environmental hazards, and makes healthcare more affordable for patients [1]. The cost of reprocessing each device is significantly lower than the cost of purchasing the original device; however, there is no information on sterilization protocols, safety, or percent failure associated with the reprocessing process of disposable surgical instruments, and in addition, many manufacturers add single-use labels to their packaging, limiting the implementation of reprocessing measures. In recent years, single-use device reuse has been a common practice in developing countries, and the main advantages of reuse policies are a reduced carbon footprint and greater environmental friendliness, as well as an attempt to reduce the cost burden on patients and hospitals, which is worthy of our country, but there are some shortcomings in the article that deserve further exploration.

The ethylene oxide mixture was circulated to sterilize the instruments and the bacteria, yeast and mycelial counts were not evaluated before and after sterilization, nor was residual ethylene oxide (ETO) tested for residual toxic substances that can cause non-infectious (sterile) endophthalmitis and toxic anterior segment syndrome (TASS) [2, 3].

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References

  1. Shah PN, Mishra DK, Shanmugam MP, Agarwal M, Susvar P, Sen AC, et al. Incidence of post vitrectomy endophthalmitis in India—a multicentric study by VRSI study Group. Eye. 2023; https://doi.org/10.1038/s41433-023-02430-1.

  2. Fong AH, Chan CK. Presumed sterile endophthalmitis afer intravitreal triamcinolone (Kenalog)-more common and less benign than we thought? Asia Pac J Ophthalmol. 2017;6:45–9.

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  3. Park CY, Lee JK, Chuck RS. Toxic anterior segment syndrome-an updated review. BMC Ophthalmol. 2018;18:1–9.

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  4. Chen G, Tzekov R, Li W, Jiang F, Mao S, Tong Y. Incidence of endophthalmitis after vitrectomy: a systematic review and meta-analysis. Retina. 2019;39:844–52.

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Authors and Affiliations

  1. Department Of Central Sterile Supply Department, The Third Affiliated Hospital of Chongqing Medical University, Chong Qing, 401120, China

    Yao Chen & Fang Zeng

  2. Nursing Department of China-Singapore Maylook Eye Hospital, Chong Qing, 401147, China

    Zi Yu Wang

Authors
  1. Yao Chen
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  2. Fang Zeng
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  3. Zi Yu Wang
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Contributions

ZYW drafted the paper and collected the data; YC and FZ revised and edited.

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Correspondence to Zi Yu Wang.

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Chen, Y., Zeng, F. & Wang, Z.Y. Comment on: Incidence of post vitrectomy endophthalmitis in India—a multicentric study by VRSI study Group. Eye 37, 3696 (2023). https://doi.org/10.1038/s41433-023-02550-8

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