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January 16, 2023
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Chang: We all should care about cataract surgery’s carbon footprint

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KOLOA, Hawaii — David F. Chang, MD, was awarded the Philip M. Corboy, MD, Memorial Award and Lecture for Distinguished Service to Ophthalmology at Hawaiian Eye 2023.

The U.S. health care sector accounts for 10% of greenhouse gas emissions in the country and is double that of other wealthy nations, but fortunately, research indicates that ophthalmologists are willing to make meaningful changes, he said.

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“There has been an alarming increase in [greenhouse gas] emissions just in the past decade. Most of this comes from the operating room, and labor and delivery,” he said. With the expected explosion of the cataract surgery in the next 2 decades, this increase is expected to continue to grow.

Chang looked at environmental sustainability lessons that can be gleaned from Aravind Eye Care System. These lessons were the focus of his Ridley Medal Lecture at the European Society of Cataract and Refractive Surgeons meeting.

Additionally, EyeSustain was created and functions as a partnership with ESCRS, the American Society of Cataract and Refractive Surgery and the American Academy of Ophthalmology. The mission of EyeSustain is to engage with the ophthalmic community about sustainability to reduce ophthalmology’s carbon footprint. Chang is the chair of the EyeSustain advisory board.

John D. Hovanesian, MD, an EyeSustain advisory board member, recently discussed the position paper on surgical waste by the Ophthalmic Instrument Cleaning and Sterilization (OICS) Task Force chaired by Drs. Chang and Cathleen McCabe, MD. Read the blog here.

Using the Aravind experience, recent papers in the medical literature and the position paper as sources, Chang shared steps ophthalmologists can take in their operating rooms now to make an impact:

  • Use multidose topical medications.
  • Update surgical packs to eliminate items not used frequently and monitor this regularly.
  • Eliminate the body and head drape.
  • Eliminate the patient gown.
  • Short cycle sterilization.
  • Consider reusable options such as diamond blades.
  • Use alcohol hand sanitizer vs. sink.
  • Use the EyeSustain to calculate carbon footprint.
  • Educate staff to inspire them to find other ways to reduce.

“Because we have the highest surgical volume in all of medicine, ophthalmology has a very unique opportunity and an obligation to make our very vital but high-volume procedures more sustainable,” Chang said.