David Chang, AAO 2018 – Updated Guidelines for Cleaning Ophthalmic Tools

Professor David F Chang met up with us at this year’s AAO meeting to discuss the recent increase in scrutiny in the US into operating room protocols and practices, and the response to form a task force from three societies – the American Society of Cataract and Refractive Surgery (ASCRS), the American Academy of Ophthalmology (AAO) and Ophthalmic Outpatient Surgery Society (OOSS) – chaired by Prof Chang and Dr Nick Mamalis to create an updated and more ophthalmology-specific set of guidelines for the cleaning and sterilization of ophthalmic surgical tools. He then goes on to discuss the latest recommendations and the problems with enzymatic cleaners.

In the second part of his interview, Professor David F Chang discusses his recent study which was presented at AAO 2018 – “Endophthalmitis Reduction with Intracameral Moxifloxacin After Posterior Capsule Rupture”. This 6-year retrospective study involving more than 1,540,000 consecutive cases of cataract surgery, half of which had intracameral moxifloxacin, which lowered the infection rate from 7/10,000 to 2/10,000. They also investigated the effect of posterior capsule rupture with and without intracameral moxifloxacin and found that the use of intracameral antibiotic was very effective. He then touches on the effect of climate change regulations on the updated guidelines for the cleaning, sterilization and reuse of ophthalmic tools.

Questions:
1. Why was there a need for updated guidelines on cleaning intraocular surgical tools? (0:11)
2. What is the latest recommendation regarding short-cycle sterilization of intraocular surgical tools? (1:10)
3. When is it appropriate to use enzymatic cleaners and what are the potential drawbacks of this approach? (2:33)

4. Tell us about your recent study: “Endophthalmitis Reduction with Intracameral Moxifloxacin After Posterior Capsule Rupture” (0:11)
5. Using fewer resources is of increasing concern in the light of evidence of climate change. How is this addressed in the new guidelines? (2:10)

Speaker disclosures: David Chang has nothing to disclose in relation to this interview.

Filmed at the American Academy of Ophthalmology (AAO) 2018 Annual Meeting, Chicago, IL, US, 27–30 October 2018.