Analysis of Intraocular Lens Packaging Weight and Waste

Purpose: To analyze waste from intraocular lens (IOL) packaging across a variety of brands. Setting: Private clinical practiceDesign: Prospective weight and composition analysis of all elements of unopened packages of IOLs sold in the US - both preloaded and non-preloaded. Methods: Samples were collected from multiple IOL companies in 2023. The primary endpoint for comparison was the total weight of each IOL package, because this generally correlates with the carbon footprint. The percentage of total weight contributed by paper, plastic, Tyvek^®, foil, sterile saline solution (fluid), metal, or glossy paper material was also calculated. Results: The non-preloaded IOL package weights ranged from 29 g (Zeiss Lucia) to 80 g (RxSIGHT LAL). Most of the weight was attributable to paper, including the box and instructions for use (IFU) pamphlet. The latter was generally the largest component within the box. The weights of preloaded IOL packages were generally higher than those of their non-preloaded counterparts and ranged from 67 g (Hoya iSert) to 116 g (Rayner RayOne Spheric). Conclusions: Meaningful differences in the IOL packaging weight and waste were noted across different models and manufacturers. Electronic IFU linked to QR codes could replace the need for an IFU pamphlet within every box, significantly reducing the box's size, weight, and carbon footprint. Pairing preloaded IOL cartridges with autoclavable injectors could reduce associated waste. Because of the enormous global volume of IOL implantation, these waste-reducing strategies should be prioritized by IOL manufacturers.