Advancing Sustainability in Ophthalmic Surgeries and Interventions: A Narrative Review of Environmental Impact and Best Practices.

Healthcare is a significant contributor to global greenhouse gas (GHG) emissions, and the field of ophthalmology, particularly through high-volume surgeries such as cataract, glaucoma, and retina interventions, has a considerable environmental impact. This review explores the environmental consequences of ophthalmic surgeries, emphasizing recent research on carbon emissions, waste production, and resource use. It also examines current sustainable practices and suggests evidence-based recommendations to mitigate the carbon footprint of ophthalmic care. Sustainability has become a critical priority in healthcare, particularly in high-volume specialties like ophthalmology, which generate significant environmental impact through resource-intensive surgical procedures. This review examines the carbon footprint of key ophthalmic surgeries-cataract, glaucoma, and retina-and identifies primary sources of emissions, including single-use disposables, energy consumption, and the use of potent greenhouse gases such as sulfur hexafluoride (SF₆) in retina surgery. Strategies to mitigate these impacts are proposed, focusing on transitioning to reusable instruments and supplies, reducing pharmaceutical waste, optimizing energy use in surgical facilities, and considering air tamponade as a viable alternative to high global warming potential (GWP) gases in retina procedures. Case studies, such as the sustainable practices at Aravind Eye Hospital, illustrate the feasibility of combining high-quality ophthalmic care with environmental responsibility. By adopting evidence-based solutions, the field of ophthalmology can significantly reduce its ecological footprint, aligning with global sustainability initiatives while maintaining patient safety and surgical efficacy.