Eyeworld

22 | EYEWORLD | SEPTEMBER 2023 ASCRS NEWS Contact Beca: flaviusbeca@med.miami.edu Gutkind: neg84@med.miami.edu Lees: beccanlees@gmail.com Pham: Ahp79@med.miami.edu Yusuf: rxy171@med.miami.edu CO 2 emissions can be achieved with universal adoption of a standardized surgical package in line with the lowest third of the materials an- alyzed. Their analysis supports this conclusion for Austria; however, the feasibility of this rec- ommendation worldwide or in the U.S. may be challenging due to the economic and legislative landscape. determine the impact of cataract surgical pack- ages on the global carbon emissions. There are additional questions raised by this study. Although the authors discussed reusable surgical equipment as a means for reducing car- bon consumption, this metric was not directly studied. The methodology assumes the selection of material with the worst life-cycle analysis from an eco-balance perspective if exact data was unavailable, but it is not mentioned how frequently this assumption was required. This may reduce the calculated effect of greenhouse gas reduction by standardizing packages. Lastly, the analysis of the surgical packs excluded other factors that contribute to the carbon footprint of cataract surgery, including disposable tubing, viscoelastic use, electricity consumption, trans- portation burden, and pharmaceutical products. A future analysis of all factors that contribute to the carbon footprint of cataract surgery may illuminate further avenues for intervention, including managing pharmaceutical waste, anal- ysis of other disposable tools, and mitigating travel and appointment burden. Conclusion The authors concluded that the large variability in the size and weights of surgical packages of- fers a strategy for reducing the carbon footprint of cataract surgery. A significant reduction in continued from page 20 Potential environmental effect of reducing the variation of disposable materials used for cataract surgery Winklmair N, et al. J Cataract Refract Surg. 2023;49:628–634. n Purpose: To analyze the cataract package variability in 1 country, Austria. n Setting: Austrian Departments of Ophthalmology. n Design: Cross-sectional study. n Methods: The cataract package components of 3 different Austrian hospitals were weighed and life cycle assessment on each product performed. This data was then extrapolated to the sales figures of the main Austrian cataract package suppliers to estimate the carbon footprint of all cataract packages used in Austria in 2021. n Results: There were 55 different cataract package compositions in use with an average weight of 0.7 kg. These compositions differ significantly in weight and composition considering that the smallest package was 57% lighter than the largest package. The size of the surgical drapes also showed considerable variation, with a difference of up to 71%. This is substantial, considering that drapes and covers account for about 53% of the package weight. n Conclusion: There was a considerable variation in package composition and product size, which could provide opportunities to save carbon dioxide emissions in cataract surgery. If all Austrian eye departments were to reduce the material quantities and drape sizes to the lower third of the cataract packages used in Austria in 2021, cataract package associated CO2 emissions could be reduced by 34%. A future analysis of all factors that contribute to the carbon footprint of cataract surgery may illuminate further avenues for intervention, including managing pharmaceutical waste, analysis of other disposable tools, and mitigating travel and appointment burden.

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