Purpose <p>The primary objective of this review is to provide a perspective on the analysis of sustainability strategies in cataract surgery and their effective implementation while ensuring patient safety.</p> Methods <p>A comprehensive literature review was conducted to identify published articles on sustainability and safety in cataract surgery, and relevant articles were evaluated.</p> Results <p>The healthcare sector accounts for approximately 4.4–5.0% of global greenhouse gas emissions, highlighting the importance of sustainability in cataract surgery, which has the highest volume among surgical procedures. The carbon footprint of a single cataract surgery is 181.8&#xa0;kg CO₂ equivalent in the United Kingdom, while it is merely 6&#xa0;kg CO₂ equivalent in the Aravind model in India. The widespread adoption of sustainable cataract surgery practices is critical for reducing environmental impacts and increasing healthcare system efficiency, while the development of research and practices in this field is of great importance for establishing a more sustainable healthcare system for future generations. The comparable postoperative endophthalmitis rates achieved between the reuse protocols applied in the Aravind system and the single-use material consumption systems preferred in developed countries serve as evidence that sustainability can be achieved without compromising patient safety. Currently, the carbon footprint of cataract surgery can be reduced by decreasing energy consumption, optimizing single-use materials, and implementing effective waste management strategies. However, regulatory policies in developed countries and differences in attitudes among ophthalmologists present challenges to the dissemination of sustainable practices.</p> Conclusion <p>This review provides evidence that sustainable practices in cataract surgery can be successfully implemented while maintaining clinical safety. The development of research and practices in this field is critically important for establishing more environmentally responsible healthcare systems for future generations. Widespread adoption of sustainable cataract surgery practices is essential for reducing environmental impacts and increasing healthcare system efficiency.</p>