PERSPECTIVE article
Front. Public Health
Sec. Planetary Health
This article is part of the Research TopicEnvironment and Healthcare, a two-way traffic: Challenges, Impacts, and Sustainable SolutionsView all 14 articles
Intraocular Gases and Climate Change: A Call for Sustainable Vitreoretinal Surgery
Provisionally accepted
Joseph Paolo Yap Silva1,2*
Recivall P Salongcay2- 1Xavier School, San Juan, Philippines
- 2The Medical City, Pasig, Philippines
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Perfluoropropane (C₃F₈) and sulfur hexafluoride (SF₆) are established agents in vitreoretinal surgery. Their tamponade properties support anatomic success, but both gases have very high global warming potentials and extremely long atmospheric lifetimes. Given the health sector’s considerable share of global greenhouse emissions, emissions attributable to intraocular gases constitute a discrete, measurable, and modifiable component of surgical practice. This Perspective synthesizes published evidence on the climate impact of C₃F₈ and SF₆ in routine vitreoretinal care and outlines actions at three levels. First, clinical practice: standardize low‑concentration mixtures, match prepared volume to need, improve decanting technique, and consider air tamponade in appropriate indications. Second, implementation systems: training, checklists, and simple process metrics (prepared‑to‑injected ratios; concentration adherence) to reduce variation and waste. Third, institutional and policy measures: procurement criteria that favor lower GWP options and right sized packaging, guideline updates, audit indicators, and product level carbon disclosure. These steps do not introduce new clinical risk when applied with standard safeguards and may yield cost savings by reducing gas consumption. Because fluorinated intraocular gases are potent, long lived, and tied to modifiable routines, targeted measures in this niche can produce outsized gains for planetary health relative to effort.
Keywords: Healthcare sustainability, Sulfur hexaflouride, Vitreoretinal Surgery, Sustainable surgical care, Carbon Footprint
Received: 15 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Silva and Salongcay. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Joseph Paolo Yap Silva, josephpy.silva@gmail.com
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