Disinfection of Multi-Use Ocular Equipment for Ophthalmological Procedures: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Key Message

One relevant economic analysis and one evidence-based guideline was identified for this review comparing clinical effectiveness of various disinfection techniques for mutli-use ocular equipment in ophthalmology patients. The identified cost-effective analysis compared alcohol swabs and peroxide bleach as a disinfection technique of tonometers. Using alcohol swabs as a base case, the cost-effective analysis demonstrated that the incremental cost-effectiveness ratio for peroxide bleach was $12,152 Canadian dollars per epidemic keratoconjunctivitis averted. The identified guideline recommends that ophthalmic equipment be cleaned immediately as per the manufacturer’s written instruction of use based on strong evidence. Additional recommendations were general and with respect to how the cleaning should be done in an adequate manner, such as, ensuring there is a designated cleaning area, enough personnel to ensure thorough cleaning and sterilization, and maintaining records of all cleaning methods.Although there is evidence regarding disinfection techniques, the clinical comparative effectiveness remains inconclusive as most of these outcomes are in vitro, making it difficult to identify the most clinically, cost-effective, and safe technique for the disinfection of multi-use ocular equipment for ophthalmic use.