Improving Sustainability In Cataract Surgery In A Single Uk Nhs Trust

Phacoemulsification has an increasingly high disposable instrument component and high carbon footprint in the UK. Demand for eye care continues to increase therefore this is an ideal area to target carbon reduction strategies. We conducted a quality improvement project to identify ways of reducing carbon footprint in our cataract service.

Cataract service in a single UK NHS trust.

The EyeSustain Carbon Estimator was used to determine the carbon footprint of a single phacoemulsification. Information was obtained from the sustainability team at our trust. Changes implemented to improve sustainability included removal of unnecessary items and increasing reusable items in the phacoemulsification pack. Alcohol-based hand rub solution was introduced alongside an informative poster to encourage theatre staff to use it.

Prior to changes made, total waste per phacoemulsification was 1481g with plastic waste contributing to 1182g. Approximate total carbon emissions per phacoemulsification was 664 kilograms of carbon dioxide equivalents (KgCO2e). Approximate total annual carbon emissions was 628,021 KgCO2e.

The EyeSustain calculator will be repeated following final implementation of the carbon footprint reduction strategies listed in the methodology. Other options to consider include increasing topical anaesthetic use, sequential bilateral cataract surgery and exploring the possibility of on-site sterilisation for same day cases.

Off-the-shelf life cycle assessment methods for carbon emissions show some variability in CO2 emissions, and we believe our slightly higher than average value was related to the size of the facility and overall water and electricity usage.

Despite this, the EyeSustain calculator is a useful tool for units to start to evaluate and reduce their cataract surgery carbon footprint.