55 EyeWorld Asia-Pacific | September 2024 About the Physicians Lee Mun Wai, MD | LEC Eye Centre, 44-46 Persiaran Greenhill, Ipoh, Perak, 30450, Malaysia | munwai_lee@lec.com.my Relevant Disclosures Lee: None References 1. Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R et al. Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet 2009; 373(9676): 1693–1733. 2. Karliner J, Slotterback S, Boyd R, Ashby B, Steele K. Health care’s climate footprint: how the health sector contributes to the global climate crisis and opportunities for action. 2019. https://www.arup.com/-/media/arup/files/publications/h/health-cares-climate-footprint.pdf. 3. United Nations Fund for Population Activities website. https://asiapacific.unfpa.org/en/populationtrends. 4. Morris DS, Wright T, Somner JEA, Connor A. The carbon footprint of cataract surgery. Eye 2013; 27:495-501. 5. Thiel CL, Schehlein E, Ravilla T, et al. Cataract surgery and environmental sustainability : waste and lifecycle assessment of phacoemulsification at a private healthcare facility. J Cataract Refract Surg 2017; 43:1391-98. 6. Venkatesh R, Landingham SW, Khodifad AM, et al. Carbon footprint and cost-effectiveness of cataract surgery. Curr Opinion Ophthalmol 2016; 27(1):82-88. 7. Buchan JC, Theil CL, Steyn A, Somner J, Venkatesh R, Burton MJ, Ramke J. Addressing the environmental sustainability of eye health-care delivery: a scoping review. Lancet Planet Health 2022 Jun; 6(6):e524-e534. 8. Chang DF. Tackling the challenges of needless surgical waste in ophthalmology. J Cataract Refract Surg 2023 Apr; 49(4):333-38. NEWS & OPINION 1. Improving Education and Awareness The first step in tackling any problem is to recognise that there is indeed a problem. The individual ophthalmologist often acts in the best interests of the patient in front of them without consideration for the wider implications on the environment and society. We have to consider a change in mindset to configure our delivery of care in a way that also protects the physical environment and acts in the collective interest of public health. 2. Collaborative Efforts Collaboration between governments, healthcare providers, academic institutions, and international organizations is essential for promoting sustainability in cataract surgery. Sharing best practices, conducting joint research, and implementing coordinated programs can amplify the impact of individual efforts. Working with industry is also crucial as many of the device manufacturers and pharmaceutical companies have started implementing green initiatives and something as simple as electronic Instructions For Use (IFU) pamphlets instead of ones printed on paper (Figure 2) would be an example of a step in the right direction. 3. Policymakers and Regulators Policymakers continue to play a critical role, and it is important to strike a balance between the risks to the individual and to the population as a whole whilst implementing regulations which govern healthcare practices7. Regulations that encourage the use of environmentally-friendly materials and promote equitable access to healthcare services can drive systemic changes towards sustainability. Conclusion Sustainability in cataract surgery in the Asia Pacific region is multifaceted, involving environmental stewardship, economic viability and social equity. Addressing these aspects through innovative practices, collaborative efforts and supportive policies can ensure that cataract surgery not only restores vision but also contributes to the broader goals of sustainable development. As the demand for cataract surgery continues to rise, integrating sustainability into every aspect of the process will be essential for delivering high-quality, accessible and environmentallyresponsible eye care to the region’s diverse populations. Editors’ note: APACRS is a member society of EyeSustain, and Dr. Lee is one of the representatives of APACRS in the EyeSustain Global Council.
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