Intraocular lens models: Ecological distribution footprint and usage trends at a large ophthalmology centre.

Background: Operating theatres significantly contribute to hospital's environmental footprint, underscoring the need to evaluate the ecological impact of transporting surgical products. Intraocular lenses (IOLs), sourced globally, vary in their environmental impact due to differences in packaging and manufacturing. Assessing the carbon footprint of IOL transport and usage can promote sustainability.

Methods: A retrospective analysis of IOL stock data at Rothschild Foundation Hospital, Paris, was conducted to evaluate all IOLs implanted in 2023. To estimate the ecological footprint of IOL transport, the packaging weight of each model was measured, and the EcoTransIT online calculator was used.

Results: In 2023, a total of 13,894 IOLs from 62 different models were implanted by 112 ophthalmic surgeons at our institution. Carbon dioxide (CO₂) emissions from the transport of IOL models varied from 1.05 to 12.72 kg per 1,000 units, influenced by packaging weight and shipping distances. Packaging volumes ranged from 135 to 917 cm³. Standard monofocal lenses comprised 65.9% of implanted IOLs, followed by monofocal "plus" lenses at 21.6%. Toric, non-toric extended depth of focus (EDOF), and non-toric multifocal lenses were used less frequently, at 7.4%, 3.9%, and 1.3%, respectively.

Conclusions: Significant disparities exist in CO₂ emissions related to IOL distribution among different IOL models, highlighting the importance of minimising packaging to reduce environmental impact. Standard monofocal lenses remain the predominant choice among surgeons, with increasing adoption of monofocal "plus" lenses. Premium lenses are used sparingly. Optimising packaging could improve storage efficiency and logistics, potentially facilitating greater adoption of premium lenses, particularly toric lenses.