{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:45:41Z","timestamp":1792259141628,"version":"4.4.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Jpn J Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To quantify waste and greenhouse gas (GHG) emissions from disposable materials used in cataract surgery in Japan and to assess pragmatic, site-selected waste-reduction interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Prospective multicenter observational and interventional (before and after) clinical study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Ten Japanese sites audited 10 consecutive standard phacoemulsification cases at baseline and after implementing low-risk intervention selected by each site and integrated into routine workflow. Disposable items were collected and weighed. GHG emissions were estimated as a partial footprint attributable to disposable materials, expressed as carbon dioxide equivalents (CO\n                      <jats:sub>2<\/jats:sub>\n                      eq), using published material emission factors and material-specific end-of-life assumptions. Primary outcomes were waste weight and GHG emissions per case.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 201 surgical procedures were analyzed (100 baseline, 101 post-intervention). Baseline mean waste was 2.28 \u00b1 0.40 kg and mean GHG emissions were 9.80 \u00b1 2.14 kg CO\n                      <jats:sub>2<\/jats:sub>\n                      eq per case; plastics were the largest contributor. Site-level medians decreased from 2.28 to 2.06 kg (P = .020) and from 9.09 to 8.35 kg CO\n                      <jats:sub>2<\/jats:sub>\n                      eq (P = .004). In mixed-effects models, reductions did not reach statistical significance (waste ratio 0.86, 95% CI 0.73\u20131.02, P = .092; GHG ratio 0.84, 95% CI 0.71\u20131.00, P = .051).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Cataract surgery in Japanese sites generates substantial disposable-material waste and associated CO\n                      <jats:sub>2<\/jats:sub>\n                      eq. Pragmatic site-selected interventions were associated with significant reductions in site-summary analyses, while case-level modeling showed similar trends without statistical significance, suggesting heterogeneity and\/or limited power.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10384-026-01429-x","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:13:50Z","timestamp":1792228430000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical waste and greenhouse gas emissions in cataract surgery: a multicenter interventional study at ten Japanese hospitals"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1897-9993","authenticated-orcid":false,"given":"Yoshitaka","family":"Takizawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Tabuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao","family":"Tanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Kihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Miyoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Kuriyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riko","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Kurimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Akimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Nakano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshifumi","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Iida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaku","family":"Kiuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Oshika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"1429_CR1","unstructured":"ARUP. 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Takizawa, None; H. Tabuchi, None; M. Tanabe, None; K. Kihara, None; M. Miyoshi, None; S. Kuriyama, None; R. Matsumoto, None; M. Fujiwara, None; Y. Kurimoto, Grants or contracts (Santen, VCCT, Vision Care, Sumitomo), Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (Chugai, Alcon, AMO, Novartis, Kowa, Bayer, Santen, Senju); M. Shimizu, None; K. Ishii, None; M. Akimoto, Consulting fees (KOWA, Chugai, AMO), Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (KOWA, Alcon, HOYA, Senju, Chugai, Santen); S. Nakano, None; Y. Okamoto, None; M. Iida, None; G. Kiuchi, Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (Santen, Menicon, Senju, Alpha corporation), Support for attending meetings and\/or travel (Alpha corporation); T. Oshika, Grants or contracts (Alcon, HOYA, Johnson & Johnson, KOWA, Santen, Senju), Consulting fees (Alcon, HOYA, Johnson & Johnson, Santen), Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (Alcon, HOYA, Johnson & Johnson, Santen), Stock or stock options (Logic & Design), Receipt of equipment, materials, drugs, medical writing, gifts or other services (Topcon).","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}