Why are ultrasonic cleaners used for the ophthalmological sector?

The ultrasonic cleaner is indispensable in ophthalmological practice, due to the proven effectiveness in cleaning the instruments used in this discipline. The cleaning of instruments for ophthalmological procedures should be a safe process, allowing the removal of the surface of the instruments, all inorganic or organic waste, or any other contaminant, prior to sterilization. Ophthalmologic surgical instruments that are inadequately sanitized may cause surgical infections, such as anterior segment toxicity syndrome.

As the complexity of surgical procedures and instruments increases, the risk of infections for patients increases. In addition, some procedures use substances that may be difficult to remove during cleaning. For example, the use of silicone oil, in vitreoretinal operations. This synthetic polymer is one of the most common contaminants in ophthalmologic surgical instruments.

This silicone oil, due to its low surface tension, spreads on the metal surface of the instruments and forms a layer or protective film on the blood and other organic debris, making it difficult to remove residual contaminants. Often, nurses or technicians in charge of cleaning the instruments say that, although they devote additional efforts and time to cleaning instruments contaminated with silicone oil, the efficiency of cleaning is often inadequate.

If the cleaning procedure is ineffective, the remaining inorganic and organic materials prevent the disinfection products from making contact with the surface of the instrument, which hinders their disinfection and sterilization. On the other hand, if the contaminated instruments dry before cleaning, the biofilm formed by the microorganisms offers resistance to antibiotics, disinfectants and sterilizing agents. This leads to the need to use direct mechanical friction or chemicals to remove the biofilm.

Particular considerations on procedures and instrumentation used in ophthalmology

In the ophthalmic sector some conditions are presented that require a different attention to the rest of the medical disciplines.  On the one hand, some procedures, such as cataracts, are shorter than many general surgical procedures, and the number of daily surgeries is often higher.

Another aspect to consider is that intraocular surgical instruments are among the smallest, compared to instruments used in other disciplines. Also, they do not get very dirty with tissue or bacterial contamination.

On the other hand, the amount of detergent or chemical contaminant that would be well tolerated in other body cavities, can cause severe intraocular inflammation if it is introduced into the eye. These considerations may differentiate optimal cleaning and sterilization procedures for ophthalmic instrumentation from those required in other disciplines.

Advantage of using an ultrasonic cleaner

An ultrasonic cleaner is a cleaning equipment that, through ultrasound and with the use of special solutions, allows the hygiene of ophthalmic instrumentation. This device can remove waste in an efficient way. However, it requires an appropriate solution for the type of instrument and the waste to be disposed of.

The high frequency waves emitted in the cleaning solution generate a phenomenon known as cavitation, which consists in the formation of small bubbles that when imploding, release energy that through a micro sweep, can release the debris attached to the instruments.

This equipment is of great help in cases of ophthalmic instruments that are difficult to clean, for example, that have hinges or plungers that get stuck by the presence of residues that cannot be removed with other cleaning methods.

Ultrasonic cleaning for ophthalmic instrumentation

Professional groups responsible for drafting the main guidelines for cleaning and sterilizing instruments used in ophthalmic surgery recommend the following:

  • Before placing the instruments in the ultrasonic cleaner, visible debris should be removed manually, as soon as possible, after use of the instrument. Waste should be prevented from drying on the instrument.
  • Once the instrument finishes the sanitizing cycle in the ultrasonic cleaner, it should be rinsed with enough water to completely remove the cleaning solution.
  • It is preferable that the ultrasonic cleaner be used only for ophthalmic instruments. If there is no alternative and the ultrasonic unit is used for other surgical instruments, it should be emptied, cleaned, and rinsed thoroughly before use with ophthalmic instruments, and thus avoid cross-contamination.
  • Ultrasonic cleaners should be emptied, cleaned, disinfected, rinsed and dried at least once a day, following the manufacturer’s recommendations.

Kalstein Ultrasonic Cleaners

A wide range of YR series ultrasonic cleaners is offered, where you can choose the most appropriate one for cleaning ophthalmological instruments. These products offer better cleaning performance and minimum noise level, high energy conversion efficiency and long service life. For more information on Kalstein ultrasonic cleaners, visit HERE