From Innovation to Conservation: Sustainable Pathways in Vitreoretinal Practice

Area of Science:

• Ophthalmology
• Environmental Science
• Surgical Innovation

Background:

• Vitreoretinal surgery's environmental burden stems from disposable instruments, fluorinated gases, and energy use.
• The practice's carbon footprint is significant and growing with increased surgical indications and single-use technologies.

Purpose of the Study:

• To review sustainability in vitreoretinal surgery.
• To identify key contributors to the carbon footprint and outline mitigation strategies.

Main Methods:

• Narrative review of current vitreoretinal surgical practices.
• Analysis of environmental impact data, focusing on tamponade agents like sulfur hexafluoride (SF₆).
• Evaluation of strategies for reducing ecological costs.

Main Results:

• Sulfur hexafluoride (SF₆) has a high global warming potential, significantly contributing to the carbon footprint.
• Inefficient gas delivery, single-use instruments, and waste disposal exacerbate environmental impact.
• Expanding surgical scope and reliance on disposables increase ecological costs.

Conclusions:

• Sustainable vitreoretinal surgery is an environmental and ethical imperative.
• Strategies include using air tamponade, gas dilution, reusable instruments, and teleophthalmology.
• Sustainability can be achieved without compromising patient outcomes.