Assessing carbon emissions in oculoplastics: blepharoplasty practices in diverse surgical settings.

Purpose: Climate change poses a significant threat to global public health, with the healthcare sector contributing substantially to greenhouse gas emissions. Ophthalmic surgeries, particularly in operating rooms (ORs), generate significant waste and carbon emissions. This study compares the environmental impact of a single bilateral upper lid blepharoplasty performed in a privately owned versus a hospital-based ambulatory surgery center (ASC).

Methods: A material flow analysis and waste audit were conducted for blepharoplasty procedures performed between June and July 2024 in two surgical settings: a privately owned ASC and a hospital-based ASC. Surgical supply inventories and utility usage were recorded through direct observation and post-operative audits. A cradle-to-grave life cycle assessment (LCA), following ISO 14,040 standards, was used to evaluate environmental impact in kilograms of carbon dioxide equivalents (kg CO₂e). Impact equivalencies were calculated for context.

Results: The hospital-based ASC generated 2,744.5 grams of waste per blepharoplasty versus 1,429.6 grams in the privately owned ASC - a 47.9% reduction. Carbon emissions were 9.7 kg CO₂e per case at the hospital-based ASC (equivalent to burning 12.1 pounds of coal), versus 5.0 kg CO₂e at the privately owned ASC (6.3 pounds of coal) - a 48.5% decrease.

Conclusions: The hospital-based ASC produces more waste and emissions per blepharoplasty than the privately owned ASC.