INFECTION PREVENTION
1 2 0
O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A P R I L 2 0 1 4
of injecting eyes with viscoelastic solution remaining on reusable can-
nulas that aren't properly flushed at the point of care.
Q What do we need to keep in mind if we add epinephrine to BSS
solution to keep pupils dilated?
A If your surgeons are using epinephrine to dilate pupils, make sure
the solution is adequately diluted, even if it's labeled preservative-free.
Of course, we recommend that you use preservative-free epinephrine,
but it's becoming increasingly difficult to find such solutions.
Epinephrine solutions that contain sodium bisulfate as stabilizing
agents are becoming more popular. Technically, these solutions are
preservative-free, but high doses of sodium bisulfate can cause issues
in the eye's anterior chamber.
Q Should we put eye instruments through an ultrasound bath?
A There's been an increased use of ultrasound baths to clean instru-
ments that haven't been properly flushed and aspirated. However,
ophthalmic instruments that have been manually cleaned and rinsed
don't need to go through an ultrasound cycle, which contains enzymes
and detergents that increase TASS risks when they remain on devices,
and ultimately aren't needed to remove the minimal amounts of
bioburden left on ophthalmic instruments after surgery. If you still
choose to run ophthalmic instruments through an ultrasound bath,
make sure you drain and clean the bath after each use. Many centers
are simply cleaning baths at the end of they day, which isn't accept-
able.
Q Is it okay to touch intraocular lenses and the tips of instruments
that go into the eye with gloved hands?
A No. Even the surfaces of powder-free gloves contain trace amounts
OSE_1404_part3_Layout 1 4/4/14 2:43 PM Page 120
