For the last few decades, there has been increasing awareness about the environmental impacts of plastics and waste products. More efforts have been made to encourage recycling and make it readily available.

However, at the same time, ophthalmologists, including us vitreoretinal surgeons, have witnessed an increase in the use of disposables. It’s relatively rare these days that we use any instrumentation that’s reusable. While our instruments are relatively small, we have to consider the packaging, too, which often accounts for a comparable if not greater amount of the medical waste than the instrument itself. This may even be more so in our offices, with many of the injectables and their associated packaging.1

While it’s easy to think that we’re only a small piece of a much larger puzzle contributing to waste, I was shocked to hear that health care in the United States has been estimated to be responsible for nearly 9 percent of greenhouse gas emissions, which, in turn, are catapulting us toward a cycle of climate change and worsening health conditions.2

Much of these emissions emanate from the manufacturing and distribution of single-use surgical and medical supplies. On one hand, single-use disposables are certainly convenient and provide consistency. No more worries about damaged reusable instruments and the associated headaches of cleaning and sterilizing between cases. Perhaps, there’s a theoretical advantage in infection control with single-use supplies, but this has not been consistently borne out in studies.

So what can we do? First, we can encourage sorting of waste and maximizing recycling efforts. As consumers of these disposable products, another important tool is advocacy, especially with manufacturers and product representatives to design supplies and instruments that use more sustainable materials and minimize the associated packaging. Perhaps it’s time for us to revisit the concept of reusable instruments, which not only improves sustainability but will also likely result in cost savings.

Other ideas include standardizing equipment use across surgeons in a given center, thereby reducing unused supplies which may expire and be discarded. In that same vein, try only to open things that are absolutely needed for each case. Work with your OR to design custom packs that only contain the supplies that are always used. Consider choosing items that use less material, such as a sterile face drape rather than a full body drape.

When we step back, the vast majority of us will agree that health- care waste is excessive in the United States.3 It’s time to fight inertia and act. Our actions today, no matter how trivial they seem, will cumulatively allow for a better tomorrow. RS

 







REFERENCES 

1. Cameron TW, Vo LV, Emerson LK, Emerson MV, Emerson GG. Medical waste due to intravitreal injection procedures in a retina clinic. J Vitreoretin Dis. 2021;5:193-198.

2. Sherry B, Lee S, Ramos Cadena MDLA, et al. How ophthalmologists can decarbonize eye care: A review of existing sustainability strategies and steps ophthalmologists can take. Ophthalmology. 2023;130:702-714.

3. Oydanich M, Khouri AS. The environmental and economic burden of surgical waste in ophthalmology operating rooms. Eye Lond Engl. 2024;38:822-823.