Utilisation Of The Sustainability Index For Disposables In Cataract Surgery (Sidics) To Measure The Sustainability And Co₂e Emissions Of A Standard Nhs Cataract Pack

Cataract surgery is a common procedure globally, but its environmental impact is growing due to the large volume of disposable consumables used. To address this issue, the Sustainability Index for Disposables in Cataract Surgery (SIDICS)is a tool developed by European Society of Cataract and Refractive Surgeons (ESCRS) to evaluate the sustainability of cataract packs and calculate the carbon footprint (CO₂e) of consumables. This study aimed to assess the sustainability of cataract packs and calculate the CO₂e emissions associated with these consumables using SIDICS.

Maidstone and Tunbridge Wells Hospital, NHS England a district general hospital

Data was collected at a district general hospital in southeast England, using a proforma to assess the usage of the components of the cataract packs during 22 cataract surgeries between 19/08/24 and 30/08/24. The study evaluated the sustainability of the standard cataract pack, which includes 19 single use items, and input these details into SIDICS software to calculate the CO₂e. We also collected data from the hospital records on the number of cataracts packs used annually at the Trust. 

In 2023, the hospital ordered 6,345 cataract packs, producing a total CO₂ footprint of 40,336 kg CO₂ e. When compared with the ESCRS benchmark, a potential CO₂ saving of 15,543 kg CO₂e was identified. During the 22 cataract surgeries in this study, certain consumables—two cannulas and an 18-gauge blunt fill needl were unused and discarded. Recommendations for reducing the environmental impact included using smaller facial drapes (saving potential of 9666kg CO2e), replacing single-use gallipots and kidney trays with reusable alternatives (saving potential of 2818 kg Co2e) and eliminating postoperative shields. These modifications could substantially lower the carbon footprint of cataract surgeries.

Considerable variation in the usage of single-use items in cataract packs presents opportunities to reduce CO₂ emissions. Optimizing the pack contents and transitioning to reusable or more sustainable alternatives will result in significant reduction in the carbon footprint of cataract surgery procedures