September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Environmental Life Cycle Assessment and Costs of Phacoemulsification at Aravind Eye Hospital in Pondicherry, India
Author Affiliations & Notes
  • Cassandra L Thiel
    Civil and Environmental Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Emily Schehlein
    Ophthalmology, University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Osamah Saeedi
    Ophthalmology, University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Joel S Schuman
    Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Alan L Robin
    Ophthalmology, University of Maryland School of Medicine, Baltimore, Maryland, United States
    Ophthalmology, Johns Hopkins University, Baltimore, Maryland, United States
  • Rengaraj Venkatesh
    Aravind Eye Care System, Madurai, India
    Glaucoma, Aravind Eye Hospital, Pondicherry, India
  • Ravindran R.D
    Aravind Eye Care System, Madurai, India
  • Ravilla D. Thulasiraj
    Aravind Eye Care System, Madurai, India
  • Footnotes
    Commercial Relationships   Cassandra Thiel, None; Emily Schehlein, None; Osamah Saeedi, None; Joel Schuman, Arie, Alcon, Glaukos, Pfizer (C), Pfizer (R), Zeiss (P); Alan Robin, Aerie, Biolight (C), Aerie, Glaukos (I), Aravind Eye Care System (S); Rengaraj Venkatesh, Aravind Eye Care System (S); Ravindran R.D, Aravind Eye Care System (S); Ravilla Thulasiraj, Aravind Eye Care System (S)
  • Footnotes
    Support  • Fulbright-Nehru Academic and Professional Excellence Award (Research) 2014-2015
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5575. doi:
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      Cassandra L Thiel, Emily Schehlein, Osamah Saeedi, Joel S Schuman, Alan L Robin, Rengaraj Venkatesh, Ravindran R.D, Ravilla D. Thulasiraj; Environmental Life Cycle Assessment and Costs of Phacoemulsification at Aravind Eye Hospital in Pondicherry, India. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5575.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There are increasing concerns about the environmental footprint and greenhouse gas emissions of healthcare, and the operating room is of particular focus. The Aravind Eye Care System has created an effective surgical model based on efficiency of time and cost, but what is the environmental footprint of this model? This study analyzes material use at Aravind Eye Hospital in Pondicherry (AEH-PDY), India and calculates the environmental emissions through Life Cycle Assessment (LCA).

Methods : We quantified and weighed surgical materials used in phacoemulsification (phaco) at (AEH-PDY). Material flow maps documented the reuse and disposal of all surgical materials for each site; average costs of materials and their disposal were calculated using hospital accounting records. Collected data were input into an LCA framework using one phaco (one eye) as the functional unit and the perioperative period as the study boundaries. Emissions throughout materials’ life cycles were calculated using the robust life cycle inventory database ecoinvent 3 and the global impact assessment method CML-IA v3.02 World 2000.

Results : Key contributors to the life-cycle environmental footprint of a single phaco at AEH-PDY include electricity, water use, and the production of single-use materials (Fig 1). Carbon emissions from surgical materials and their disposal (including reusable and single-use items, Fig 2) average about 0.8kg CO2-eq per phaco, well below the reported average of 63.5kg CO2-eq per phaco in the UK (Morris, et al. 2013).

Conclusions : Results show that Aravind’s efficiency-focused surgical model minimizes environmental emissions and costs associated with phaco. Aravind’s current initiative to install solar photovoltaic panels for electricity generation will likely further reduce their overall footprint. Given Aravind’s proven surgical outcomes (Haripriya, et al. 2012), other hospitals should consider components of this model when attempting to reduce the environmental and cost burdens of surgical care.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Life-Cycle Environmental Impacts of Phacoemulsification (Phaco) at Aravind Eye Hospital, Pondicherry (AEH-PDY); *Cost does not include water or capital equipment

Life-Cycle Environmental Impacts of Phacoemulsification (Phaco) at Aravind Eye Hospital, Pondicherry (AEH-PDY); *Cost does not include water or capital equipment

 

Material Flow for Surgical Materials Used in Phacoemulsification (Phaco) at Aravind Eye Hospital, Pondicherry (AEH-PDY); RO-Reverse Osmosis, IOL- Intraocular Lens, ETO- ethylene oxide

Material Flow for Surgical Materials Used in Phacoemulsification (Phaco) at Aravind Eye Hospital, Pondicherry (AEH-PDY); RO-Reverse Osmosis, IOL- Intraocular Lens, ETO- ethylene oxide

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