Assessment Of The Environmental Impact Of A Multi-Use Cassette Phacoemulsification System : A Prospective Study On Reducing The Carbon Footprint In Cataract Surgery

The healthcare sector, although fundamental to patient care, represents a substantial proportion of global greenhouse gas (GHG) emissions,estimated at 4.4% according to the EyeSustain initiative. Over 70% of this impact is attributable to the life cycle of medical devices and consumables. In the face of pressing environmental challenges, evaluating the environmental footprint of medical technologies has become imperative.

The aim of this study is to evaluate surgical performance, operating room efficiency, and resource consumption associated with a multi-use cassette phacoemulsification platform in cataract surgery in a real-world academic setting, with a focus on sustainability outcomes.

Tertiary academic ophthalmology center, Rothschild Foundation, Paris, France

This prospective observational study included consecutive cataract surgeries performed using a multi-use cassette phacoemulsification system (SOPHI platform) in one operating room from october 2025 to date of submission.

Data collected included surgical time, total operating room time, balanced salt solution (BSS) consumption, and use of consumables (tubing sets, cassettes). Time measurements were prospectively recorded and standardized. Descriptive analyses were performed to assess surgical throughput and intraoperative resource utilization.

109 patients during 21 surgical sessions were included. Each cassette was used for a mean of 5 procedures. A total of 21 cassettes, 88 tubing packs, 109 phaco packs, 109 I/A packs, and 55 BSS bottles were used. Mean BSS use corresponded to approximately 200 mL per patient.

Mean surgical time was 15 minutes 06 seconds (range 6–29), and mean total operating room time was 35 minutes 24 seconds (range 19–47). Average waste weight per patient was 131.93 g and average waste volume per patient was estimated 77.34 cm³

No intraoperative complications or device-related adverse events were observed. Variability in surgical throughput was partly related to dual-room workflow organization and resident training during the study period.

The use of a multi-use cassette phacoemulsification platform was associated with reduced material consumption and efficient surgical workflow without safety concerns. These findings support the feasibility of integrating reusable technologies into cataract surgery pathways to improve environmental sustainability while maintaining operative performance.