Journal francais d'ophtalmologie · 2026
Carbon footprint of cataract surgery in a French university hospital: Accurate assessment and new avenues for improvement.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Assafiri Y, Arndt C, Razlog E, Denoyer A
Аннотация
INTRODUCTION: Cataract surgery, one of the most performed procedure in the world reaching over 20 million procedures per year. Climate change is leading more and more healthcare professionals to evaluate their practices from an environmental point of view. With this in mind, and with the view to subsequently proposing measures for the eco-design of care, our objective was to evaluate the carbon footprint in a French University Hospital (Reims, France).
MATERIAL AND METHODS: We conducted a single-center medico-environmental prospective observational study. Carbon emissions have been divided into two categories: direct and indirect. Among the direct emissions, we collected the mode of transport, and the distance travelled to and from the site by patients and staff; the annual energy consumption was collected and adjusted according to the operating surface area and the energy consumption linked to sterilization. Among the indirect emissions, we carried out a life cycle assessment of single-use instruments and pharmaceutical products using the economic input-output life cycle assessment (EIO-LCA) method; waste was also weighed and its emissions assessed. We excluded from our analysis all causes assumed to account for less than 1% of total carbon emissions (building construction, operating microscope and phacoemulsifier). We converted the raw data into CO2 equivalents using conversion coefficients provided by various environmental databases (base empreinte; DEFRA's emissions factors, greenhouse gases protocol).
RESULTS: The carbon footprint for cataract surgery in our University Hospital was 97.28kgCO2eq (min: 85kgCO2eq; max: 127.54kgCO2eq; SD: 12.36). Single-use instruments were responsible for most of these emissions (63%), followed by pharmaceutical products (17.9%), patient and staff transport (13.71%), energy consumption in the operating theatre (2.7%), sterilization (1.76%) and waste (0.88%). As a result, the carbon footprint of one cataract surgery is equivalent to that of a 450-km trip by car.
CONCLUSION: Our study confirms the major impact of disposable instruments on carbon emissions in cataract surgery and, through this analysis, opens new avenues to propose solutions for more sustainable development in surgery.
MATERIAL AND METHODS: We conducted a single-center medico-environmental prospective observational study. Carbon emissions have been divided into two categories: direct and indirect. Among the direct emissions, we collected the mode of transport, and the distance travelled to and from the site by patients and staff; the annual energy consumption was collected and adjusted according to the operating surface area and the energy consumption linked to sterilization. Among the indirect emissions, we carried out a life cycle assessment of single-use instruments and pharmaceutical products using the economic input-output life cycle assessment (EIO-LCA) method; waste was also weighed and its emissions assessed. We excluded from our analysis all causes assumed to account for less than 1% of total carbon emissions (building construction, operating microscope and phacoemulsifier). We converted the raw data into CO2 equivalents using conversion coefficients provided by various environmental databases (base empreinte; DEFRA's emissions factors, greenhouse gases protocol).
RESULTS: The carbon footprint for cataract surgery in our University Hospital was 97.28kgCO2eq (min: 85kgCO2eq; max: 127.54kgCO2eq; SD: 12.36). Single-use instruments were responsible for most of these emissions (63%), followed by pharmaceutical products (17.9%), patient and staff transport (13.71%), energy consumption in the operating theatre (2.7%), sterilization (1.76%) and waste (0.88%). As a result, the carbon footprint of one cataract surgery is equivalent to that of a 450-km trip by car.
CONCLUSION: Our study confirms the major impact of disposable instruments on carbon emissions in cataract surgery and, through this analysis, opens new avenues to propose solutions for more sustainable development in surgery.