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New research · Ophthalmology
Ophthalmology · 22h
Meta-analysisOphthalmology · 2026

Environmental Impact of Eye Care Procedures and Visual Healthcare Services: A Systematic Review and Meta-Analysis.

Ana Paula Oliveira, Clara Martinez-Perez
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OphthalmologyMeta-analysis

Reusable surgical instruments can significantly cut emissions in eye care procedures.

Environmental Impact of Eye Care Procedures and Visual Healthcare Services: A Systematic Review and Meta-Analysis.

Ana Paula Oliveira et al. · Ophthalmology · 2026
Background

CLINICAL RELEVANCE: Eye care procedures, including cataract surgery, one of the most common globally, generate considerable carbon emissions and waste.

Methods

Data were extracted independently by 2 reviewers following Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines and assessed for methodological quality using the Methodological Index for Non-Randomized Studies tool.

n = 26 studies
96%
Results
reduction in emissions
reusable surgical tools significantly reduced carbon pollution
n = 26 studies
More results

From 14 955 initial records, 26 studies met inclusion criteria, with 15 eligible for meta-analysis.

Reported carbon footprints varied widely across procedures and settings, with substantial heterogeneity (I² = 100%) precluding the calculation of a meaningful pooled estimate.

More results

Cataract surgery exhibited the highest reported footprint (up to 322 kg CO₂e), followed by trabeculectomies (99-126 kg CO₂e) and intravitreal injections (13.7-277 kg CO₂e).

Consumption per cataract surgery varied between 17.8 and 35.09 kWh, strongly influenced by the source of electricity.

“
Conclusion · 1 of 4

Eye care procedures contribute significantly to healthcare's environmental burden.

Conclusion · 2 of 4

Targeted sustainability interventions, supported by systemic institutional reforms, offer promising pathways to reduce emissions and promote environmentally responsible visual healthcare.

Conclusion · 3 of 4

However, conclusions should be interpreted with caution, given the low to very low certainty of the available evidence.

Conclusion · 4 of 4

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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