Work

Carbon footprint of Pars plana vitrectomies in rhegmatogenous retinal detachment in Germany between 2013 and 2023 - A cohort study of fluorinated gas emissions

Year: 2025

Type: article

Abstract: Purpose Climate change, largely driven by greenhouse gas emissions, is a global threat. The healthcare sector contributes significantly − 4.4% of global and 5.2% of Germany’s CO 2 emissions. Rhegmatogenous retinal detachment (RRD) is a common ophthalmic emergency requiring surgical intervention to prevent blindness. Fluorinated gases (FG) such as SF 6 , C 2 F 6 , and C 3 F 8 are routinely used in pars plana vitrectomy (ppV) due to their expansive properties, but they have a strong greenhouse effect. With an European Union-wide ban under consideration, this study assesses the associated emissions from ppV for RRD in Germany. Methods We analyzed DRG-coded ppV data for RRD (2013–2023) from the German Federal Statistical Office. A national survey of vitreoretinal surgeons provided information on endotamponade preferences. CO 2 -equivalent emissions (CO 2 EM) were calculated using GWP100 values from the IPCC report. Results Between 2013 and 2023, 354,505 ppV for RDD were performed in Germany. Gas tamponade was used in 55.3% of cases, silicone oil in 27.7%, and air in 16.9%. FG resulted in 201.34 tons of CO 2 EM. SF 6 contributed 170.10 tons (84.5%), C 2 F 6 26.84 tons (13.3%), and C 3 F 8 4.40 tons (2.2%). This represents 18.3 tons of CO 2 EM annually, corresponding to 0.000003% of Germany’s total CO 2 EM and 0.00003% of healthcare sector emissions. Conclusion This first comprehensive analysis of FG consumption and CO 2 EM in ppV for RRD in Germany shows that FG contribute a negligible portion to Germany’s and healthcare-related CO 2 EM. Gas tamponade remains crucial for the treatment of RDD and should therefore not be banned until proven alternatives exist. Further studies are needed to explore alternatives.

Source: Graefe s Archive for Clinical and Experimental Ophthalmology

DOI: 10.1007/s00417-025-06905-7

Authors: Piotr Strzalkowski, Alicja Strzalkowska, Mathias Roth, Sema Kaya, Gerd Geerling, Rainer Guthoff

Institutions: Düsseldorf University Hospital, Heinrich Heine University Düsseldorf

Language: English

Topic: Retinal and Macular Surgery

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDGs: Climate action, Good health and well-being, Responsible consumption and production

Open Access status: hybrid

Estimated APC paid: $2,990