Potential Cost Savings Associated with a Multiuse Preoperative and Preinjection Eyedrop Protocol

[Sustainable development and eco-design of ophthalmology care: review of the literature]

In recent decades, medical advances in both diagnosis and treatment have led to a significant increase in the number of procedures performed. As a result, the environmental impact of medical activity continues to grow. The goal of this literature review is to examine the integration of sustainable development (SD) and eco-design of care in ophthalmology and to highlight strategies for reducing greenhouse gas (GHG) emissions. After defining the terms, issues involved, and various methods of analysis, this review will focus on the environmental impact of cataract surgery, intravitreal injections, and eye drops. It will also propose areas for improvement to minimize the ecological impact of our activity. The adoption of these practices might respond to the growing concerns of healthcare professionals in the face of climate change, while preserving the quality of care provided.

So Many Injections, So Much Waste: Understanding the Environmental Impact of Intravitreal Injections

Purpose: To understand the environmental burden associated with intravitreal injections (IVIs) and propose actionable solutions to mitigate this impact. Methods: An analysis of current IVI practices was conducted, focusing on packaging waste, energy consumption, the carbon footprint, and disposal processes. Data on the environmental footprint of IVIs were collected from the literature and industry reports. Sustainable practices were evaluated for their feasibility and impact on reducing waste and emissions. Industry efforts to address these environmental concerns were also surveyed. Results: This study found that the packaging of IVI medications, especially brand-name drugs, generates considerable waste. In addition, transportation and storage of these medications substantially contribute to carbon emissions. Implementing take-back programs, reducing packaging size, and using reusable or biodegradable coolers could significantly decrease waste. Adopting multidose packaging and streamlining injection practices can reduce both waste and costs. Sustainable practices have the potential for considerable environmental and economic benefits without compromising patient care. Conclusions: Addressing the environmental burden of IVIs requires a multifaceted approach involving many different parties. Collaboration among retina specialists, industry partners, and stakeholders is essential to foster sustainable practices, reduce waste, and minimize carbon emissions. This effort will ensure that our commitment to patient care matches our commitment to environmental stewardship.

Eco-sustainability in ophthalmology

PURPOSE OF REVIEW

The purpose of this review is to evaluate the current state of eco-sustainability in ophthalmology, highlighting key practices, recent advancements, and areas requiring improvement. This review aims to provide ophthalmologists with a comprehensive overview of sustainable practices that can reduce environmental impact.

RECENT FINDINGS

Recent studies have identified several areas within ophthalmology where sustainable practices can be implemented including multidose eyedrops, adjusting surgical packs, making package inserts available electronically, and reusing surgical instruments. Moreover, there is an increasing emphasis on waste reduction both in the surgical and clinical setting, by decreasing the use of unnecessary materials and implementing more efficient use of recycling programs. Telemedicine has also emerged as a sustainable option, reducing the carbon footprint associated with patient travel. Despite these advancements, significant challenges remain, particularly in balancing the cost and accessibility of sustainable options with traditional practices.

SUMMARY

Eco-sustainability in ophthalmology is gaining momentum as the medical community aims to reduce its environmental impact. While progress has been made, further efforts are required to overcome financial and logistical barriers to widespread implementation. Continued research, education, and policy development are essential to advancing eco-sustainable practices, ensuring that environmental considerations become an integral part of ophthalmic care.

Tracing the barriers to decarbonising ophthalmology: A review

As climate change demands increasingly urgent mitigation of greenhouse gas emissions, the health sector needs to do its part to decarbonise. Ophthalmologists share concerns about climate change and seek opportunities to reduce their environmental impact. When measuring the footprint of ophthalmology, major contributions are from patient travel to clinics, and from the large amounts of single-use disposable materials that are consumed during surgeries and sterile procedures. Ophthalmic services in India have already demonstrated systems that consume far fewer of these products through efficient throughput of patients and the safe reuse of many items, while maintaining equivalent safety and quality outcomes. Choosing these low-cost low-emission options would seem obvious, but many ophthalmologists experience barriers that prevent them operating as Indian surgeons do. Understanding these barriers to change is a crucial step in the decarbonisation of ophthalmology and the health sector more broadly.

How Ophthalmologists Can Decarbonize Eye Care: A Review of Existing Sustainability Strategies and Steps Ophthalmologists Can Take

TOPIC

Understanding approaches to sustainability in cataract surgery and their risks and benefits.

CLINICAL RELEVANCE

In the United States, health care is responsible for approximately 8.5% of greenhouse gas (GHG), and cataract surgery is one of the most commonly performed surgical procedures. Ophthalmologists can contribute to reducing GHG emissions, which lead to a steadily increasing list of health concerns ranging from trauma to food instability.

METHODS

We conducted a literature review to identify the benefits and risks of sustainability interventions. We then organized these interventions into a decision tree for use by individual surgeons.

RESULTS

Identified sustainability interventions fall into the domains of advocacy and education, pharmaceuticals, process, and supplies and waste. Existing literature shows certain interventions may be safe, cost-effective, and environmentally friendly. These include dispensing medications at home to patients after surgery, multi-dosing appropriate medications, training staff to properly sort medical waste, reducing the number of supplies used during surgery, and implementing immediate sequential bilateral cataract surgery where clinically appropriate. The literature was lacking on the benefits or risks for some interventions, such as switching specific single-use supplies to reusables or implementing a hub-and-spoke-style operating room setup. Many of the advocacy and education interventions have inadequate literature specific to ophthalmology but are likely to have minimal risks.

CONCLUSIONS

Ophthalmologists can engage in a variety of safe and effective approaches to reduce or eliminate dangerous GHG emissions associated with cataract surgery.

FINANCIAL DISCLOSURE(S)

Proprietary or commercial disclosure may be found after the references.