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Reducing our carbon footprint as vitreoretinal surgeons—what can we do as a group?

Eye volume 38, pages 393–394 (2024)Cite this article

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The National Health Service (NHS), the largest employer in Europe, has set a target to become the world’s first net zero healthcare system by 2040 [1]. The environmental impact of gases used in vitreoretinal surgery (VR), namely SF6, C2F6 and C3F8, can be estimated using their global warming potential (GWP), which are 22,800, 11,900 and 8600, respectively. The atmospheric lifetime of these gases, which is likely to affect their overall environmental impact, is 3200, 10,000 and 2600 years, respectively [2].

We conducted a pilot study by substituting 8% C2F6 in cases where we would have used 20% SF6. We enrolled a total of 27 patients having VR surgery [indications: retinal detachments (18), macular holes [3], epiretinal membranes [3]]. The patients noted down the date of disappearance of the gas bubble and the time taken for complete resolution of the gas bubble was calculated.

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Fig. 1: Time taken for the dissipation of 6% C3F8 gas.

Data availability

The data that support the findings of this study are available from the corresponding author, LJ, upon reasonable request.

References

  1. Introduction from: NHS England and NHS Improvement. Delivering a Net Zero National Health Service. 2020. Accessed May 2020. https://www.england.nhs.uk/greenernhs/publication/delivering-a-net-zero-national-health-service.

  2. Inventory of U.S. Greenhouse Gas Emissions and Sinks: 1990–2018. 2020 Complete Report (PDF). 2022, https://www.epa.gov/ghgemissions/inventory-us-greenhouse-gas-emissions-and-sinks-1990-2018.

  3. Moussa G, Ch’ng SW, Park DY, Ziaei H, Jalil A, Patton N, et al. Environmental effect of fluorinated gases in vitreoretinal surgery: a multicentre study of 4877 patients. Am J Ophthalmol. 2022;235:271–9.

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Authors and Affiliations

  1. Bristol Eye Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street, Bristol, BS1 2LX, UK

    Lona Jawaheer

  2. Darlington Memorial Hospital, County Durham and Darlington NHS Foundation Trust, Hollyhurst Road, Darlington, DL3 6HX, UK

    Fong May Chew

  3. Moorfields Eye Hospital, 162 City Road, London, ECV12 2PD, UK

    Christopher Holmes

  4. Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Kemptown, Brighton, BN2 5BF, UK

    Haifa Madi & Edward Hughes

Authors
  1. Lona Jawaheer
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  2. Fong May Chew
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  3. Christopher Holmes
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  4. Haifa Madi
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  5. Edward Hughes
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Contributions

LJ: Contributed to the study design, writing of the protocol, patient recruitment, data collection, data analysis, writing of the article and references. FMC: Contributed to patient recruitment, study design, article review CH: Contributed to patient recruitment, data collection, writing and review of article HM: Contributed to patient recruitment, data collection and article review. EH: Contributed to the study design, review of protocol, patient recruitment, data collection, data analysis, and review of article.

Corresponding author

Correspondence to Lona Jawaheer.

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The authors declare no competing interests.

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Jawaheer, L., Chew, F.M., Holmes, C. et al. Reducing our carbon footprint as vitreoretinal surgeons—what can we do as a group?. Eye 38, 393–394 (2024). https://doi.org/10.1038/s41433-023-02638-1

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  • DOI: https://doi.org/10.1038/s41433-023-02638-1

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