Eyeworld

16 | EYEWORLD | SEPTEMBER 2023 ASCRS NEWS EYESUSTAIN UPDATE by Sjoerd Elferink, MD and Shefali Sood, MD About the physicians Sjoerd Elferink, MD Co-founder Dutch Working Group on Sustainable Ophthalmology Flevoziekenhuis Amsterdam, Netherlands Shefali Sood, MD PGY-1 Ophthalmology Resident Georgetown University/ Washington Hospital Center Washington, D.C. conducted by the Ophthalmic Instrument Cleaning and Sterilization (OICS) Task Force, investigators surveyed the attitudes of cataract surgeons belonging to the American Society of Cataract and Refractive Surgery (ASCRS), the American Academy of Ophthalmology (AAO), the Outpatient Ophthalmic Surgery Society (OSS), and the Canadian Ophthalmology Soci- ety (COS) toward OR policies, surgical waste, sustainability, and climate change. 1 Approxi- mately 86% of respondents to this initial survey practiced in North America. A follow-up study using an identical ques- tionnaire was disseminated to members of the European Society of Cataract and Refractive Sur- geons (ESCRS) to investigate consensus in atti- tudes and foster global alliances among North American and European ophthalmologists. 2 Approximately 1,241 ophthalmologists participated in the OICS study and 458 in the ESCRS study. The cohorts were demographically similar; however, while a majority of ESCRS respondents performed cataract surgery in hos- pitals, a majority of OICS respondents operated in ASCs. Despite differences in practice location, opinions about and behaviors toward surgi- cal waste were similar between the cohorts, demonstrating universal deviations from con- ventional beliefs about single-use products and traditional operating room policies. More than 90% of respondents from both cohorts expressed concern about global warm- ing/climate change and thought that surgical waste generated during cataract surgery was ex- cessive. More than 60% of respondents in both cohorts thought that the main drivers of OR waste stemmed from perceived safety benefits of single-use items and that manufacturers: 1) produce these single-use items with packaging creating unnecessary waste, 2) drive the market toward more profitable, single-use products to limit liability, and 3) lack environmental/car- bon footprint considerations. One noteworthy Contact Elferink: sjoerd.elferink@gmail.com Sood: shefalisood12@gmail.com Eliminating operating room waste: A paradigm-altering global movement among ophthalmologists The 2022 publication 1 regarding surgical waste by Chang and Thiel brought to light the percep- tions of more than 1,300 cataract surgeons and ophthalmology operating room nurses belonging to the American Society of Cataract and Refractive Surgery, the American Academy of Ophthalmol- ogy, the Outpatient Ophthalmic Surgery Society, and the Canadian Ophthalmological Society. Their responses overwhelmingly demonstrat- ed that surgeons and operating room staff are concerned about global warming and think that surgical waste is excessive and that regulations are overly restrictive. The scope of the survey was limited to North America, and we know that the issue of surgical waste extends globally, primar- ily in developed nations. A European Society of Cataract and Refractive Surgeons survey 2 pub- lished this year sought to understand the opinions of our European peers. In this EyeSustain Update column, Sjoerd Elferink, MD, and Shefali Sood, MD, review this publication and highlight the similarities and differences among respondents from both surveys. Aakriti Garg Shukla, MD EyeSustain Editor I n 2022, the Dutch healthcare sector ac- counted for 7.3% of the national climate change footprint and 4.2% of waste gen- erated. 3 Almost 5,000 miles away, approx- imately 10% of greenhouse gas emissions and more than 4 billion pounds of waste in the U.S. were produced by its own healthcare sector. 4,5 A significant portion of healthcare-asso- ciated waste (>~70%) is generated from ORs. In 2019, it was estimated that annually, unused pharmaceutical products during cataract surgery generated 23,000 to 105,000 metric tons of unnecessary CO 2 eq emissions in the U.S. 6 The environmental impact of the waste generated in ORs has not gone unnoticed by ophthalmologists. In a landmark study

• Blank Page