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September 15, 2023
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Study: Cataract surgery produces three times the waste of major oculoplastic surgery

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VIENNA — A study carried out in a U.K. university teaching hospital found that cataract surgery produces a disproportionate amount of inappropriate clinical waste as compared with major oculoplastic operations.

With more than 450,000 procedures performed annually, cataract surgery is an ideal target to reduce health care-related carbon emissions, Kar Yen Phoong, MD, said at the European Society of Cataract and Refractive Surgeons meeting.

Kar Yen Phoong, MD

“Every cataract surgery that is performed within the U.K. emits approximately 130 kg of carbon dioxide equivalent, which is also equivalent to driving a petrol car for 762 km,” she said.

All clinical and nonclinical waste produced from 24 cataract operations and six oculoplastic procedures was analyzed and evaluated to identify unnecessary clinical waste and recyclable waste.

“We found that phacoemulsification cataract surgery produces three times more waste compared to a major oculoplastic surgery, mostly due to excessive plastic used in custom cataract packs. As much as 60% of the clinical waste generated from a cataract surgery is unnecessary, and most of it is recyclable,” Phoong said.

Incineration of clinical waste emits four times more CO compared with recycling and is more expensive. It is therefore important to develop waste management strategies within ophthalmology based on five criteria: reduce, reuse, recycle, rethink and research.

Reducing waste by draining the remaining balanced saline solution down the sink would spare 875 kg of CO. Giving the topical medication used as a single dose in the OR to the patient to bring back home would save a further 0.55 Kg. Other suggestions included redesigning more environmentally friendly cataract packs with less plastic and replacing disposable equipment with reusable equipment whenever possible.

“Educating the team about the costs and the environmental impact of inappropriate waste disposal is very important as well. So, we have attached laminated posters with the costs and the carbon dioxide emission from waste disposal onto our operating theater to promote awareness,” Phoong said.

Last but not least, more research is needed. “Every single small step can make a huge difference,” she said.