A Carbon Footprint Analysis Of Nd:Yag Capsulotomy For Posterior Capsular Opacification In A Uk Hospital

The environmental impact from routine healthcare procedures is under scrutiny in an increasingly climate conscious world. Nd:YAG capsulotomies are performed to treat posterior capsule opacifications (PCOs), the most common complication post-cataract surgery. Hydrophilic IOLs are known to be associated with an increased incidence of PCOs compared to hydrophobic IOLs. A carbon footprint analysis was conducted to quantify the environmental impact of performing a Nd:YAG capsulotomy at a UK eye hospital. The purpose of this study was to increase awareness of the environmental impact associated with Nd:YAG capsulotomy and highlight the potential for contributing to a greener NHS by reducing the requirement for the procedure.

Bristol Eye Hospital, United Kingdom

This study describes the carbon footprint of performing Nd:YAG capsulotomy procedures at an eye hospital in the United Kingdom. The carbon footprint is quantified by computing the total mass of carbon dioxide equivalent (kgCO2e) created per Nd:YAG capsulotomy procedure. Both patient and staff travel time and mode of transport were estimated using hospital travel survey data. Electricity and gas consumption was estimated from yearly Nd:YAG capsulotomy totals. Equipment use, materials and packaging use, material transportation, and waste disposal was also used. These data were used to calculate the contribution of greenhouse gas emissions caused by each activity or material required per Nd:YAG capsulotomy procedure at the UK hospital.

The average Nd:YAG procedure created emissions of 11.14 kgCO2e. The largest contributor of emissions (7.43 kgCO2e/procedure) was patient travel, as the average patient traveled 2.59 times to complete referrals, assessments, and the procedure. Staff travelled 1.4x per 8 procedures and contributed only 0.50 kgCO2e. Each procedure used 0.72 kgCO2e of building electricity and 1.00 kgCO2e natural gas. Material transport and waste disposal contributed <0.01 kgCO2e per procedure, while the procurement and packaging of materials created 1.49 kgCO2e. This was mostly due to the Nd:YAG laser (1.40 kgCO2e/procedure). Assuming 60,000 Nd:YAG procedures are performed in the UK per annum, we estimate the carbon footprint would be up to 670,000 kgCO2e.

This study looked at procedural waste created, patient and staff travel, material transportation, material packaging and use, and gas and electricity use to determine the average kgCO2e emitted per Nd:YAG capsulotomy procedure performed in a UK hospital setting. Common procedures such as these cause a significant impact to the environment, contributing to healthcare-related greenhouse gas emissions. Reducing the Nd:YAG capsulotomy rate after cataract surgery has the potential to significantly reduce the environmental impact of ophthalmic care performed by NHS hospitals.