Surgical waste generated in phacoemulsification versus manual small-incision cataract surgery

Purpose: To compare the surgical waste generated by two different cataract surgery techniques, phacoemulsification versus manual small incision cataract surgery (MSICS). Methods: : The amount of disposable waste was assessed by weighing the plastic and glass items used during a single uncomplicated cataract surgery for two cataract surgery techniques, phacoemulsification and manual small-incision cataract surgery (MSICS), including the packaging for each item. Results: : We found that in a typical phacoemulsification case, the weight of the single-use disposable waste totaled 252.4 g, compared to a typical MSICS case, which totaled 125.5 g. Materials that are used in both procedures (e.g. drapes and prep materials, balanced saline solution, viscoelastic, lens, etc.) were considered “neutral” and not individually weighed. Conclusions: : The waste generated by a standard phacoemulsification cataract surgery is roughly twice that of that generated by MSICS, revealing a striking difference between the two techniques. A major contributor is the cartridges, wiring, and tubing required for phacoemulsification and irrigation/aspiration. In addition to producing more waste, particularly plastic waste, phacoemulsification also generates more energy via the phacoemulsification machine. These data suggest that MSICS may be a more environmentally sustainable technique for cataract surgery. More research is needed to better describe the carbon footprint of various ophthalmic practices, particularly pertaining to cataract surgery.