Journal
JOURNAL OF CATARACT AND REFRACTIVE SURGERY
Volume 43, Issue 11, Pages 1391-1398Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcrs.2017.08.017
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Funding
- Fulbright-Nehru Academic and Professional Excellence Award through the United States India Educational Foundation, New Delhi, India
- Career Development Grant from the U.S. National Institutes of Health, Bethesda, Maryland, USA [K23 EY025014]
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Purpose: To measure the waste generation and lifecycle environmental emissions from cataract surgery via phacoemulsification in a recognized resource-efficient setting. Setting: Two tertiary care centers of the Aravind Eye Care System in southern India. Design: Observational case series. Methods: Manual waste audits, purchasing data, and interviews with Aravind staff were used in a hybrid environmental lifecycle assessment framework to quantify the environmental emissions associated with cataract surgery. Kilograms of solid waste generated and midpoint emissions in a variety of impact categories (eg, kilograms of carbon dioxide equivalents). Results: Aravind generates 250 grams of waste per phacoemulsification and nearly 6 kilograms of carbon dioxide-equivalents in greenhouse gases. This is approximately 5% of the United Kingdom's phaco carbon footprint with comparable outcomes. A majority of Aravind's lifecycle environmental emissions occur in the sterilization process of reusable instruments because their surgical system uses largely reusable instruments and materials. Electricity use in the operating room and the Central Sterile Services Department (CSSD) accounts for 10% to 25% of most environmental emissions. Conclusions: Surgical systems in most developed countries and, in particular their use of materials, are unsustainable. Results show that ophthalmologists and other medical specialists can reduce material use and emissions in medical procedures using the system described here. (C) 2017 ASCRS and ESCRS
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