Authors
Franka Wehrle, Hansjürgen Thomas Agostini, Karl Ulrich Bartz-Schmidt, H Burkard Dick, Gerd Geerling, Adrian Gericke, Hans Hoerauf, Christoph Holtmann, Paul Kohlhas, Thabo Lapp, Norbert Pfeiffer, Berthold Seitz, Martin S Spitzer, Maria Steuernagel, Marcus Werner Storch, Suphi Taneri, Focke Ziemssen, Christian Girbardt
Published in
Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde. Pages 1. Aug 31, 2026. Epub Aug 31, 2026.
Abstract
Introduction Outpatient cataract surgery is one of the most frequently performed surgical procedures worldwide. Reducing its carbon footprint without compromising hygiene and patient safety offers substantial potential for mitigating healthcare-related greenhouse gas emissions. This multicentre study quantified the carbon footprint of outpatient cataract surgery across ten heterogeneous German tertiary centres and examined inter-centre variability in emissions as well as the extent to which current data support transparent, standardised reporting. Methods Between December 2022 and March 2023, standardised on-site assessments collected data on staff and patient travel, electricity consumption, disposable material use, and waste generation. Data were converted into carbon dioxide equivalents (CO₂e) using emission factors from national environmental agencies. Since detailed life cycle and sterilisation data could not be obtained for instrument manufacture and reprocessing, these components were modelled for all centres. Results The centres showed substantial inter-site variation in all major emission categories. Disposable materials (2.53-8.30 kg CO2e) and sterilisation (2.62-7.13 kg CO2e) were the dominant contributors, together accounting for 56.6-84.6% of total emissions. Electricity use contributed 1.0% to 18.5%, whereas waste disposal remained low (≤0.4%). Based on the combination of measured and modelled components, the estimated carbon footprint averaged 14.09 kg CO₂e per cataract procedure (95% CI: 12.08-16.11 kg), with centre-level values ranging from 10.07 to 18.70 kg. Conclusion Substantial emission reductions can be achieved by streamlining material use and improving sterilisation workflow. Transparent reporting that defines system boundaries, specifies uncertainties, and provides access to data collection methods is essential for comparability and for establishing reliable benchmarks in sustainable surgical practice. This study provides a comprehensive multicentre carbon footprint analysis for outpatient cataract surgery in Germany and offers a transparent framework that guides targeted reduction strategies.
PMID:
42671945
Bibliographic data and abstract were imported from PubMed on 01 Sep 2026.
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