Abstract
Purpose :
Healthcare delivery is a major contributor to global greenhouse gas emissions, especially within the surgical suite. Ophthalmologists play a role in generating this waste as they frequently perform high volume procedures, such as cataract surgery. Standardized approaches to study this topic will enable development of a clearer understanding and targeted strategies to reduce the carbon footprint. This scoping review summarizes the current literature on surgical waste in ophthalmology and suggests a framework for future studies.
Methods :
The protocol and reporting methods were based on PRISMA guidelines for scoping reviews. A literature review was conducted with 2 independent reviewers using PubMed, Embase and Google Scholar. Articles that reported any quantitative measurement of waste produced from ophthalmic surgeries were eligible for inclusion. Commentaries, opinion papers, reviews and articles in a non-English language were excluded. Full text articles were reviewed and relevant data was extracted. Relevant data includes title, first author, publication year, study design, location, surgery type and type/amount of waste measured.
Results :
A total of 713 articles were reviewed with 10 articles that met inclusion criteria. Descriptions of included studies can be found in Table 1. There were six studies that were level 3 evidence, two level 4 evidence and two level 5 evidence. The total waste produced was reported in carbon emissions (KgCO2) and mass of solid waste (Kg). Studies addressed different components of the waste lifecycle (Figure 1) in order to estimate total operating room waste. The average carbon emissions per surgery was 85.2 KgCO2 with a range of 5.9 KgCO2 to 181.8 KgCO2. Across studies, the majority of waste came from procurement of surgical materials, followed by travel emissions and building energy (Table 1).
Conclusions :
Research on waste produced in ophthalmic surgery is limited, and existing studies utilize varied approaches to quantify this waste. We propose a standardized waste lifecycle framework for researchers to organize future research. Such standardization may better enable comparison across studies, and this may uncover more opportunities to implement impactful waste reduction strategies in ophthalmology.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.