Standpoint on Sustainability (SOS): John Hovanesian

Power Lister John Hovanesian talks about the role he plays in the global cooperative EyeSustain, surgical waste management, and how it might benefit us to pay closer attention to the sustainability practices of developing nations.

How are you working towards sustainability in ophthalmology?
 

I’m one of many volunteers involved in EyeSustain, a global cooperative of physicians, societies, and industry, which is committed to reducing surgical waste and our environmental impact. My role is leading our industry initiatives, in which physicians liaise with companies.

What has changed in terms of how practitioners and the industry have addressed sustainability in the last decade?
 

The biggest change is that everyone now agrees that surgical waste is a problem. This includes the industry and our physician colleagues, as well as regulators and lawmakers, who are now committed to change. But unraveling decades of regulations is not easy, and manufacturers have to respect the laws of each country where they sell products. Such major hurdles can create the attitude that such complicated rules can’t be unraveled. But I continue to be inspired by all the people, especially young people, who are promoting this cause and the belief that we can make a difference.

Sustainability is a ubiquitous topic at industry events and meetings. But how genuinely is ophthalmology invested in it?
 

Before EyeSustain had a name, David Chang and Cassie Thiel conducted an online survey of more than 1300 cataract surgeons and nurses. Of those who responded, 93 percent believed that operating room waste is excessive and should be reduced; 78 percent believed that we should reuse more supplies; 90 percent were concerned about global warming; and 87 percent wanted medical societies to advocate for reducing the surgical carbon footprint.

Is it realistic to achieve a global buy-in to the sustainability mindset?
 

Interestingly, some of the most inspiring work in sustainability is being done in the developing world. Facilities like the Aravind Eye Hospital system in India waste a small fraction of what we do in the United States, and they have demonstrated, through literally millions of surgeries, that their methods are just as safe – at least from a standpoint of postoperative endophthalmitis – as surgery in the United States.

How can all of ophthalmology’s stakeholders work together to reach goals in sustainability?
 

The best first step for every surgeon and facility is to take the EyeSustain pledge – a simple commitment you make to taking incremental steps toward reducing waste. You can find the pledge on the EyeSustain website.

Another step is to express to product vendors your desire for smaller packaging and less wasteful product design. This powerful message gets attention from decision-makers in every company. And the good news is many of those decision-makers are just as motivated to reduce waste as we physicians are – hearing a supportive voice of the customer gives them fuel to take action.

What sustainability goals would you like to see the profession reach in the next 5-10 years?
 

We’d like to see the majority of surgical eye care practices around the world take the EyeSustain pledge. We’d also like to see the global adoption of electronic instructions for use in surgical packaging, not just for intraocular lenses but for all products. This can occur in other surgical specialties as well. Finally, we’d like to see future revisions of regulations that consider sustainability as a priority along with patient safety.

John Hovanesian is a cataract and cornea specialist at Harvard Eye Associates in southern California, where he conducts clinical research and serves as a consultant to many drug, device, and medical technology companies. He has been named to The Ophthalmologist Power List.