ArticleEye (London, England)2025
The Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: report 19, a comparative study of the cost and carbon footprint of local anaesthesia techniques for cataract surgery.
Article in Eye (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Greening healthcare through circular economy: advancing health and sustainability in policy and practice.European journal of public health · 2026Review
- Sustainability practices made easy.Eye (London, England) · 2025Review
- Comment on: 'The Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: report 19, a comparative study of the cost and carbon footprint of local anaesthesia techniques for cataract surgery'.Eye (London, England) · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnderstanding the financial and environmental impact of clinical pathways is important for designing sustainable services. This study aimed to compare the cost and carbon footprint of sub-Tenon's and topical anaesthesia for cataract surgery, benchmark minimum topical anaesthesia utilisation rates, and quantify the benefits of increased topical anaesthesia usage in the United Kingdom National Health Service (NHS).
methodsThe cost and carbon footprint of products and staffing for topical and sub-Tenon's anaesthesia for cataract surgery were calculated and applied to National Ophthalmology Database audit data. A mainly process-based approach was used to estimate the carbon dioxide equivalent (CO2e) of product production, usage, and waste disposal.
resultsThe typical CO2e per case was 0.71 kg for topical anaesthesia and 1.19 kg for sub-Tenon's anaesthesia. Around a third of CO2e was generated by usage of unneccesary equiptment and wasteful practices. The typical cost per case was £14.60-£17.14 for topical anaesthesia, £27.74 for sub-Tenon's anaesthesia performed by an operating department practitioner and £56.15 for sub-Tenon's anaesthesia performed by a consultant anaesthetist. It is estimated that around 25,000 NHS cataract cases could annually be converted from sub-Tenon's to topical anaesthesia, which would reduce the CO2e emissions of services by 12,000 kg while saving £265,000 on product usage and between £63,500 and £773,750 on staffing.
conclusionsTopical anaesthesia is a cheaper and more environmentally sustainable alternative to sub-Tenon's anaesthesia for cataract surgery. Increased topical anaesthesia usage in cataract services could contribute towards the NHS aspiration of becoming "net zero" by 2040.
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Registered trials
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