New guidance on ophthalmology from the ACDP TSE Working Group
The ACDP TSE Working Group have published new guidance on ophthalmology and CJD/vCJD.
This new guidance, "Annex L - Managing CJD/vCJD risk in ophthalmology", is available on the
DH website at: http://www.dh.gov.uk/ab/ACDP/TSEguidance/index.htm
This new guidance includes the following key information:
· Clarification of the definition of anterior and posterior segment eye surgery
1 Posterior segment eye surgery is high risk surgery
2 Allogeneic sclera is a high risk tissue, and thus all procedures involving use of this tissue are high risk
3 Anterior segment eye surgery and eye examination are low risk. Anterior eye tissues have previously been designated medium risk - this has now changed. Please note that Annex A1 and Part 4 of the ACDP TSE Working Group guidance will be updated shortly with this new designation for anterior eye tissues
4 Recipients of ocular transplants are not designated as at risk of CJD or vCJD
5 Disposable ophthalmic examination instruments should be used for those patients designated at increased risk of CJD or vCJD. The use of disposable examination instruments is encouraged in all other circumstances provided the cost and quality are acceptable
6 Instruments used for ophthalmic surgery on patients with CJD/vCJD or designated as at increased risk of CJD/vCJD can be quarantined for re-use exclusively on the same patient
7 Endorsement of NICE Guidance IP196 eliminating migration of instruments for all eye surgery. Provision of pragmatic solutions for adherence to NICE Guidance 196
8 Provision of new generic information for eye units with regard to cleaning and decontamination of ophthalmic surgical instruments to:
· Encourage communication between eye units and decontamination services
1 Encourage pre-washing in surgical units or alternatively use of gels/foams/ mists to keep instruments moist during transportation
2 Encourage investment in specialist ophthalmic trays for washer disinfectors
