Journal francais d'ophtalmologie · 2026
The comparative environmental impacts of ophthalmic subspecialty procedures at a hospital-based versus a private ambulatory surgical center.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Hu D J, Lee M J, Wang E, Duker J, Janigian R, Ducharme J, Migliori M, Rizzuto P R
Аннотация
PURPOSE: To assess and compare the waste generation and carbon footprint of vitrectomy, blepharoplasty, and phacoemulsification performed in hospital-based outpatient operating rooms (ORs) versus a private ambulatory surgical center (ASC).
MATERIALS AND METHODS: A hybrid prospective life cycle assessment (LCA) was conducted at a hospital-based outpatient operating and a private ambulatory surgical center using waste audits and analysis of surgical supplies (process-based) and pharmaceuticals (economic input-output). One standard, uncomplicated case of each procedure type was evaluated at each site, for a total of 6 audited cases. Study boundaries were limited to intraoperative surgical and pharmaceutical supplies and excluded sterilization, building energy, device operation, travel, and other perioperative activities. Main outcomes included waste by weight and environmental impact in kg carbon dioxide equivalents (kg CO2eq).
RESULTS: For non-pharmaceutical surgical supplies, vitrectomy generated the highest waste and emissions (3573g; 12.79kg CO2eq), followed by phacoemulsification (2776g; 9.17kg CO2eq) and blepharoplasty (2087g; 7.19kg CO2eq). Across the three audited procedure types, ASC supply waste was 34% lower and supply-related emissions were 31% lower than in the hospital OR. Plastics constituted 85% of total waste, with nonwoven polypropylene and low-density polyethylene being major contributors to emissions. Pharmaceutical use added 25.55kg, 93.15kg, and 12.83kg CO2eq for vitrectomy, phacoemulsification, and blepharoplasty, respectively, but these estimates were derived using a price-based EIO method and are therefore reported separately.
CONCLUSION: Within the defined study boundaries and audited cases, the ASC cases showed lower measured waste and lower measured carbon emissions than the hospital-based OR cases. Observed differences were associated primarily with site-specific practice patterns, including draping, packaging, consumable use, and medication management, rather than facility type alone. Targeted strategies and OR policy change can substantially decrease the carbon footprint of ophthalmic surgery while maintaining high standards of care.
MATERIALS AND METHODS: A hybrid prospective life cycle assessment (LCA) was conducted at a hospital-based outpatient operating and a private ambulatory surgical center using waste audits and analysis of surgical supplies (process-based) and pharmaceuticals (economic input-output). One standard, uncomplicated case of each procedure type was evaluated at each site, for a total of 6 audited cases. Study boundaries were limited to intraoperative surgical and pharmaceutical supplies and excluded sterilization, building energy, device operation, travel, and other perioperative activities. Main outcomes included waste by weight and environmental impact in kg carbon dioxide equivalents (kg CO2eq).
RESULTS: For non-pharmaceutical surgical supplies, vitrectomy generated the highest waste and emissions (3573g; 12.79kg CO2eq), followed by phacoemulsification (2776g; 9.17kg CO2eq) and blepharoplasty (2087g; 7.19kg CO2eq). Across the three audited procedure types, ASC supply waste was 34% lower and supply-related emissions were 31% lower than in the hospital OR. Plastics constituted 85% of total waste, with nonwoven polypropylene and low-density polyethylene being major contributors to emissions. Pharmaceutical use added 25.55kg, 93.15kg, and 12.83kg CO2eq for vitrectomy, phacoemulsification, and blepharoplasty, respectively, but these estimates were derived using a price-based EIO method and are therefore reported separately.
CONCLUSION: Within the defined study boundaries and audited cases, the ASC cases showed lower measured waste and lower measured carbon emissions than the hospital-based OR cases. Observed differences were associated primarily with site-specific practice patterns, including draping, packaging, consumable use, and medication management, rather than facility type alone. Targeted strategies and OR policy change can substantially decrease the carbon footprint of ophthalmic surgery while maintaining high standards of care.