into contact with during reprocessing. Make sure that the solution is
compatible with materials found in your ultrasonic washers and auto-
mated endoscope reprocessors. This can include stainless steel, soft
metals like aluminum and a variety of plastics.
7 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 6
Enzymatic cleaners are likely to do
more harm than good when used to
clean ophthalmic instruments, accord-
ing to 3 major ophthalmic groups.
Though some ophthalmic instru-
ment manufacturers recommend
using enzymatic cleaners, detergents
often contain exotoxins that aren't
denatured by autoclave sterilization,
the American Society for Cataract
and Refractive Surgery (ASCRS), the American Academy of Ophthalmology (AAO) and the
Ophthalmic Outpatient Surgery Society (OOSS) said last month in a statement. They say that
corneal endothelial toxicity and TASS (toxic anterior segment syndrome) have both been
associated with the use of enzymatic detergents.
Because intraocular instruments acquire little bioburden during surgery, prompt manual rins-
ing and cleansing after surgery should be sufficient to remove bioburden, the groups say. They
also caution those who continue to use enzymatic detergents to carefully follow instructions for
proper dilution, and to use sterile distilled or sterile deionized water for the final instrument
rinse.
Bottom line? Based on documented risk of TASS, and with no proven benefit for endoph-
thalmitis prevention, don't use enzymatic detergent to routinely decontaminate intraocular
instruments. — Jim Burger
THE BIG EXCEPTION
Don't Use Enzymatic Detergents For Ophthalmic Instruments
• BAD IDEA Ophthalmic groups recommend not using enzymatic solutions on
your eye instruments.
