{
  "abstract": "Introduction: Outpatient cataract surgery is one of the most frequently performed surgical procedures worldwide. Reducing its carbon footprint without compromising hygiene and patient safety offers substantial potential for mitigating healthcare-related greenhouse gas emissions. This multicentre study quantified the carbon footprint of outpatient cataract surgery across ten heterogeneous German tertiary centres and examined intercentre variability in emissions as well as the extent to which current data support transparent, standardised reporting.\n\nMethods: Between December 2022 and March 2023, standardised on-site assessments collected data on staff and patient travel, electricity consumption, disposable material use, and waste generation. Data were converted into carbon dioxide equivalents (CO2e) using emission factors from national environmental agencies. Since detailed life cycle and sterilisation data could not be obtained for instrument manufacture and reprocessing, these components were modelled for all centres.\n\nResults: The centres showed substantial inter-site variation in all major emission categories. Disposable materials (2.53–8.30 kg CO2e) and sterilisation (2.62–7.13 kg CO2e) were the dominant contributors, together accounting for 56.6–84.6% of total emissions. Electricity use contributed 1.0%–18.5%, whereas waste disposal remained low (≤0.4%). Based on the combination of measured and modelled components, the estimated carbon footprint averaged 14.09 kg CO2e per cataract procedure (95% CI: 12.08–16.11 kg), with centre-level values ranging from 10.07 to 18.70 kg.\n\nConclusion: Substantial emission reductions can be achieved by streamlining material use and improving sterilisation workflow. Transparent reporting that defines system boundaries, specifies uncertainties, and provides access to data collection methods is essential for comparability and for establishing reliable benchmarks in sustainable surgical practice. This study provides a comprehensive multicentre carbon footprint analysis for outpatient cataract surgery in Germany and offers a transparent framework that guides targeted reduction strategies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology, University of Leipzig Medical Centre, Leipzig, Germany",
    "Eye Centre, Medical Faculty, University of Freiburg, Freiburg, Germany",
    "Department of Ophthalmology, University Eye Hospital Tübingen, Tübingen, Germany",
    "Eye Hospital, Ruhr University Bochum, Bochum, Germany",
    "Department of Ophthalmology, University Hospital Düsseldorf, Düsseldorf, Germany",
    "Department of Ophthalmology, University Medical Centre Mainz, Mainz, Germany",
    "Department of Ophthalmology, University Medical Centre Göttingen, Göttingen, Germany",
    "Department of Ophthalmology, Saarland University Medical Centre, Homburg, Germany",
    "Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany",
    "Eye Department, Centre for Refractive Surgery Münster, Münster, Germany"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Franka Wehrle"
    },
    {
      "affs": [
        1
      ],
      "name": "Hansjürgen Agostini"
    },
    {
      "affs": [
        2
      ],
      "name": "Karl Ulrich Bartz-Schmidt"
    },
    {
      "affs": [
        3
      ],
      "name": "H. Burkhard Dick"
    },
    {
      "affs": [
        4
      ],
      "name": "Gerd Geerling"
    },
    {
      "affs": [
        5
      ],
      "name": "Adrian Gericke"
    },
    {
      "affs": [
        6
      ],
      "name": "Hans Hoerauf"
    },
    {
      "affs": [
        4
      ],
      "name": "Christoph Holtmann"
    },
    {
      "affs": [
        7
      ],
      "name": "Paul Kohlhas"
    },
    {
      "affs": [
        1
      ],
      "name": "Thabo Lapp"
    },
    {
      "affs": [
        5
      ],
      "name": "Norbert Pfeiffer"
    },
    {
      "affs": [
        7
      ],
      "name": "Berthold Seitz"
    },
    {
      "affs": [
        8
      ],
      "name": "Martin S. Spitzer"
    },
    {
      "affs": [
        8
      ],
      "name": "Maria Steuernagel"
    },
    {
      "affs": [
        6
      ],
      "name": "Marcus W. Storch"
    },
    {
      "affs": [
        9
      ],
      "name": "Suphi Taneri"
    },
    {
      "affs": [
        0
      ],
      "name": "Focke Ziemssen"
    },
    {
      "affs": [
        0
      ],
      "name": "Christian Girbardt"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4et61hbhqcx62.bib",
  "cited_by": 0,
  "doi": "10.1159/oph/aeeag011",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13722464/",
  "id": "4et61hbhqcx62",
  "issns": [
    "0030-3755",
    "1423-0267"
  ],
  "landing_url": "https://doi.org/10.1159/oph/aeeag011",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2305|Environmental Impact and Sustainability"
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  "openalex": "W7204861582",
  "pdf_url": "https://karger.com/oph/article-pdf/doi/10.1159/oph/aeeag011/4580992/000554034.pdf",
  "pmcid": "PMC13722464",
  "pmid": "42671945",
  "published": "2026-08-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4et61hbhqcx62.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T12:22:57Z",
      "native_id": "PMC13722464",
      "source": "pmc",
      "url": "https://doi.org/10.1159/oph/aeeag011"
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  "subjects": [
    {
      "field": "earth",
      "origin": "openalex:2305|Environmental Impact and Sustainability",
      "subfield": "environmental-science"
    }
  ],
  "title": "Carbon Footprint of Outpatient Cataract Surgery in Germany: Multicentre Analysis of Emission Sources, Variability, and Opportunities for Transparent Reporting",
  "title_text": "Carbon Footprint of Outpatient Cataract Surgery in Germany: Multicentre Analysis of Emission Sources, Variability, and Opportunities for Transparent Reporting",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:57Z",
  "url": "https://research.draconitic.com/paper/4et61hbhqcx62",
  "venue": "Ophthalmologica. International Journal of Ophthalmology",
  "versions": []
}