A Multifaceted Approach in Minimizing Pharmaceutical Waste in Ophthalmic Surgery

There is an urgent need to address the significant issue of pharmaceutical waste production during ophthalmic surgery. The waste includes topical medications that are unused or lightly used and thrown away after cataract surgery. Multiple studies demonstrate this reality, revealing that many eye drops remain unused upon disposal, translating to unnecessary environmental impact. Fortunately, a multi-pronged approach can effectively combat this issue.

Standardized Reuse of Multidose Eye Drops

Surgical centers and hospitals should establish protocols permitting the safe reuse of multidose eye drops across multiple patients. This demonstrably safe practice offers significant environmental and economic benefits. A collaborative research project involving video recordings of trained technicians administering preoperative eye drops revealed zero instances of contamination among a substantial number of administrations. Notably, over 50% of surgeons currently refrain from utilizing multidose medications due to institutional regulations against reuse, as highlighted by a relevant task force survey. Additionally, research suggests that a protocol for multiuse dilating drops in the preoperative setting can significantly reduce medication usage. Also, this results in substantial cost savings for institutions.

Utilizing Medications Until Manufacturer Expiration

Current practices often involve prematurely discarding properly stored multidose eye drops, adhering to arbitrary post-opening use-by dates instead of manufacturer expiration dates. Dr. Wiley Chambers, Director of the FDA Office of Specialty Medicine’s Division of Ophthalmology, clarified in a 2021 editorial that the 28-day use-by date misinterpretation stemmed from regulations intended for injectable multidose medications, not topical ophthalmic products. This misapplication has led to the unnecessary disposal of partially used eye drops well before their intended expiry.

Empowering Patients with Take-Home Medications

Standard practice should encompass allowing patients to take home partially used topical medications following surgery. A recent survey revealed that only a minority of ophthalmologists follow this practice. This is primarily due to facility regulations and pharmacy constraints. Regional variations necessitate addressing these barriers potentially at the state level. Illinois serves as a successful example, with a relevant medical society collaboration leading to a resolution permitting proper labeling and distribution of unused portions of preoperatively ordered topical medications for post-surgical care. The model legislation, readily available on the American Academy of Ophthalmology website, offers a valuable framework for other states seeking to implement similar regulations for widespread patient take-home use of partially used ophthalmic medications.

Call to Action:

MedPro Disposal supports healthcare facilities in implementing sustainable waste management practices. We offer comprehensive solutions for safely disposing of expired and unused medications, ensuring compliance with all relevant regulations. Contact MedPro today to discuss how we can partner with your facility to minimize pharmaceutical waste and contribute to a healthier environment.