I thought surely the eye Doctors' Academy (that provides the Doctors with the board certification they put in their bios) would have a policy designed to protect patients' safety.  Think again.

"At this time, the Academy [The American Academy of Ophthalmology] does not have a formal policy on the issue [reusing Microkeratome blades on multiple patients without sterilization]."

"Use them once and throw them away, or resterilize them and use them again? Increased FDA oversight of companies that reprocess single-use devices is sparking an uproar."

"It’s an issue mired in economics and politics—and patient safety. And while the focus thus far has been primarily on disciplines like cardiology and interventional radiology, ophthalmology has not escaped scrutiny."

For instance, several years ago, Northern California–based LaserVue Eye Center was involved in a widely publicized lawsuit alleging it reused microkeratome blades that could have potentially exposed patients to infectious diseases or uneven flaps. The lawsuit stemmed from an investigation by the California Department of Health, which found that the center’s surgeons had rinsed and reused microkeratome blades and hand pieces instead of sterilizing them.

The health department’s investigation revealed that microkeratome blades were rinsed with sterile water and reused on a second patient provided that 1) with the first patient, the blade worked properly and there was no visible bleeding and 2) less than 30 minutes elapsed between patients. The microkeratome assembly was rinsed and reused for up to four consecutive patients. While no actual infections were reported, the department required the eye center to notify some 2,700 LASIK patients that their surgeons had rinsed and reused the blades.

While this is a rare and extreme case of misuse, it does raise the question of whether the reuse and reprocessing of single-use devices should be more tightly regulated. At this time, the Academy does not have a formal policy on the issue. Several aspects of single-use devices and the practice of ophthalmology should be considered before any guidelines are developed, noted Richard L. Abbott, MD.

“First of all, this is an issue where there are no absolutes,” he said. “What may be applicable for one type of single-use device, for example a microkeratome blade, may not be relevant for another device, for instance a phacoemulsification tip. Second, we need to take into consideration several issues, including whether the design of the instrument or device is amenable to reuse, whether it can be appropriately sterilized, whether reuse will compromise its function in any way—potentially altering outcomes—and whether the device will perform at the same level with the same quality for multiple uses given proper sterilization techniques. But again, this needs to be determined on a case-by-case basis.”