Assessing Waste Production Of Ophthalmic Surgeries And Clinical Practices, Hamilton Regional Eye Institute

Ophthalmic surgical procedures commonly occur in large numbers globally and contribute significantly to greenhouse gas emissions and environmental waste within the health sector. This study assessed the quantity and categorization of waste generated from ophthalmic surgeries and clinics over one week. 

The study occured over onew week at Hamilton Regional Eye Institute, St. Joseph's Healthcare Hamilton in the surgical and clinic rooms. 

The surgical waste was categorized into preoperative, intraoperative, and postoperative waste and further classified as general or reusable waste. The surgeries analyzed included phacoemulsification (91 cases), corneal surgeries such as penetrating keratoplasty (2 cases), retina surgeries (10 cases) including pars plana vitrectomy, and glaucoma surgeries (9 cases) such as bleb, ahmed valve implant, and trabeculectomy with mitomycin. Over one clinic week, 1237 patients were audited and waste generated was examined and categorized based on ophthalmic clinic and administration specialties (neuro-ophthalmology, glaucoma, retina, and resident clinic) and further categorized into regular solid waste, recyclables, and sharps items.

112 ophthalmic surgeries were performed, generating total of 618.35 kgs of waste: 360.43 kgs of general and 257.92 kgs of reusable waste. The general waste produced from phacoemulsification surgery produced 306.02 kgs, keratoplasty was 5.624kgs, vitrectomy was 18.25 kgs, and glaucoma surgeries was 30.52kgs. The average general waste production per case of any ophthalmic surgery was 3.2 kg, resulting in 1.44 kilograms of CO2 equivalents in our facility. Across all clinic offices, recyclable waste (220.66kg) contributed to the most waste, followed by garbage waste of 21.89kg, and sharps waste of 3.62kg. This totals to approximation of 11,474.32kg of recyclables, 1,138.28kg of garbage waste, and 188.24kg of Sharp’s waste is produced per year.

These findings provide a comprehensive understanding of waste generation in ophthalmology surgeries. The disproportionate generation of general waste compared to reusable waste underscores the necessity of implementing waste management systems aligned with the principles of reduce, reuse, and recycle, in line with the United Nations' Sustainable Development Goals for 2030. This study demands a rethinking of operating room protocols to reduce waste generation and paves the way for innovative waste management strategies.