Sustainability Assessment Of Cataract Surgeries Using The Eyefficiency Application At Maidstone Hospital, Kent, Uk.

Cataract surgery is one of the most frequently performed procedures worldwide, and its environmental impact, particularly carbon emissions and waste, has become a growing concern. The Eyefficiency application, developed by the RCOphth Sustainability Working Group and funded by a World Bank research grant, offers a tool to assess sustainability in cataract surgeries. The application collects key data on productivity, patient complexity, staffing, and environmental factors, allowing comparisons between global units. The study aimed to assess the sustainability of cataract surgeries at Maidstone Hospital using Eyefficiency. Permissions to use the web-based toolkit were obtained.

District General Hospital, South East England

Data were collected at a district general hospital care NHS facility in southeast England, between 29/11/24 and 06/12/24 through a time and motion study. Information on service details, appointment patterns, staff details, building and energy use, theatre operations, waste disposal, consumables including pharmaceuticals, reusable instruments, and surgical linen was gathered and incorporated in the Eyefficiency application. Permissions to use the application were obtained prior to data collection. This data was processed to generate a sustainability report, comparing local performance with global averages.

The sustainability assessment revealed that each cataract surgery generated 695.47 kg CO₂e, significantly higher than the global average of 96.69 kg CO₂e. The breakdown of CO₂ emissions included 30.46 kg from the production of disposable/consumable supplies (excluding pharmaceuticals), 14.38 kg from pharmaceutical supplies, and 641.46 kg from the disposal of supplies. Additionally, the hospital generated 3.29 kg of waste per cataract surgery, compared to the global average of 0.82 kg. The total cost per surgery at Maidstone was GBP 652.23, while the global average cost was GBP 235.91.

The sustainability assessment of cataract surgeries highlighted significant disparities in carbon emissions, waste generation, and cost compared to the global averages. These findings provide insight into areas where changes could be made to reduce the carbon footprint, including optimizing consumable use, improving waste management, and reducing energy consumption. This toolkit offers valuable data to help eye units, governments, and NGOs benchmark their performance and work toward more sustainable practices in cataract surgery.