Abstract
PurposeTo report the potential reduction of carbon emissions by utilising air-tamponade (AT), where possible, instead of fluorinated gases in the management of rhegmatogenous retinal detachment (RRD). We compared the carbon CO2 emissions produced at two large tertiary referral vitreoretinal (VR) centres where RRD are exclusively repaired using fluorinated gases to a tertiary VR mass of each gas used according to the Intergovernmental Panel on Climate Change.Materials and methodsRetrospective, continuous, comparative multicentre study of all procedures using fluorinated gases between 01/01/17-31/12/20 at the Manchester Royal Eye Hospital (MREH) and Birmingham and Midland Eye Centre (BMEC), and between 01/01/19-31/12/2020 at the University Hospitals Coventry and Warwickshire (UHCW).ResultsWe report on 3,239 (SF6:1,415 [43.7%], C2F6:1,235 [38.1%], C3F8:541 [16.7%], Air:48 [1.5%]) procedures. UHCW and BMEC utilise single use 30ml and 75ml cannisters, respectively and MREH use multi-use gas cylinders. UHCW used AT in 48 (70%) of RRD repairs. Mean equivalent mass CO2/patient was MREH:115.9kg, BMEC:7.9kg and UHCW:1.9kg. If assuming all centres used 30ml cannisters, the mean equivalent mass CO2/patient was MREH:3.5 kg, BMEC:3.1kg and UHCW:1.9kg. AT enabled UHCW to greatly reduce the need for the most environmentally damaging SF6 gas, leading to lower CO2 emissions by 47.0% and 41.1% compared to MREH and BMEC, respectively.ConclusionWe demonstrate how AT vs. the fluorinated gases can reduce in carbon footprint in the management of RRD. Further studies are required to determine the most ‘environment-friendly’ intraocular tamponade without compromising patient outcomes centre that also routinely employs AT in selected RRD cases.
Highlights
The fluorinated gases used in vitreoretinal (VR) surgery which include sulphur hexafluoride (SF6), hexafluoroethane (C2F6) and octafluoropropane (C3F8) are among the most potent greenhouse gases [1]
air tamponade (AT) enabled University Hospitals Coventry and Warwickshire (UHCW) to greatly reduce the need for the most environmentally damaging SF6 gas, leading to lower CO2 emissions by 47.0% and 41.1% compared to Manchester Royal Eye Hospital (MREH) and Birmingham and Midland Eye Centre (BMEC), respectively
In this paper we primarily reported the potential reduction of carbon emissions by utilising AT instead of fluorinated gases in the management of rhegmatogenous retinal detachments (RRD)
Summary
The fluorinated gases used in vitreoretinal (VR) surgery which include sulphur hexafluoride (SF6), hexafluoroethane (C2F6) and octafluoropropane (C3F8) are among the most potent greenhouse gases [1]. There is increasing evidence in the literature on the excellent safety profile of air tamponade (AT) compared to gas in repairing selected rhegmatogenous retinal detachments (RRD) and some authors suggested utilising AT to reduce carbon emissions [4]. In this paper we primarily reported the potential reduction of carbon emissions by utilising AT instead of fluorinated gases in the management of RRDs. In our analysis we compared the CO2 emissions produced at two large tertiary referral vitreoretinal (VR) centres where RRD are exclusively repaired using fluorinated gases to a tertiary VR centre that routinely employs AT in selected RRD cases
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
