Asha S. Jain, BS; Jennifer Larson, MD
WMJ. 2026;125(4):489-491. Published November 1, 2026.
ABSTRACT
Introduction: The American Academy of Ophthalmology has reported that each cataract surgery in the United States produces 2.3 to 3.9 kg of waste. Studies from the Aravind Eye Care System in India have shown that, despite reusing surgical supplies between patients, postoperative endophthalmitis rates were lower than those reported in the United States. This suggests that much of the surgical material used in the United States may be unnecessary to prevent endophthalmitis. Identifying strategies to reduce waste generated by ophthalmic surgery is important. The purpose of this study was to determine whether postoperative endophthalmitis rates differed between cataract surgeries performed using full- or three-quarter-size surgical drapes.
Methods: We conducted a retrospective review comparing the use of Alcon full-size (6500 in2) and three-quarter-size (3465 in2) surgical drapes for phacoemulsification cataract surgery at a university-affiliated ambulatory surgery center between 2020 and 2024. Outcomes included postoperative endophthalmitis rates, surgical waste generated (in2), and cost.
Results: A total of 21469 cataract surgeries were completed at the University of Wisconsin-Madison (UW Health’s) ambulatory surgery center between 2020 and 2024. A total of 4897 (22.81%) cases used three-quarter-size surgical drapes and 16 572 (77.19%) used full-size surgical drapes. There were no cases of endophthalmitis in either group. Compared with full-size drapes, the three-quarter-size drapes reduced material use by 47% and saved $17,139.50.
Conclusions: No difference in postoperative endophthalmitis rates was observed between groups. Therefore, three-quarter-size surgical drapes may represent an acceptable alternative to full-size drapes for improving the sustainability of cataract surgery.