Surgical drape waste in pediatric ophthalmology: examining the sustainability of strabismus surgery

In pediatric ophthalmology, routine use of adult-sized drapes creates preventable waste. The goal of this study was to quantify the environmental impact of draping in pediatric strabismus surgery.

This was an observational study of draping practices in pediatric strabismus surgeries conducted between October 1, 2024, and July 15, 2025, at Ann & Robert H. Lurie Children's Hospital of Chicago, a tertiary pediatric hospital. All strabismus surgeries conducted by 8 ophthalmologists during the study period were included. Drape usage and wastage were quantified. Patient height and weight were also recorded. Primary outcome was emissions in kilograms of carbon dioxide (kg CO₂eq) from drapes. Secondary outcomes included proportion of drapes unused, difference in emissions between standard and alternative draping practices, and draping surface area relative to patient body surface area (BSA).

Across 174 cases, 56% of drapes were unused, causing mean wastage of 1.67 drapes and 2.73 kg CO₂eq per case. Alternative draping was used in 72% of cases. Two such practices produced greater emissions than standard draping and two produced fewer; overall, alternative draping produced 0.19 fewer kg CO₂eq in mean emissions per case. Total draping surface area was 5.5 times greater than patient BSA on average, producing 6.95 kg CO₂eq per case from excess draping.

Draping practices in pediatric strabismus surgery result in significant waste from unused and oversized drapes. Aligning surgical pack contents with surgeon preferences, adoption of size-appropriate drapes, and exploration of reusable alternatives may reduce the environmental impact of pediatric strabismus surgery.