Purpose

This study aimed to assess waste production in oculoplastic operating rooms (ORs) at tertiary care centres and identify potential interventions to improve sustainability practices without compromising patient safety.

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Methods

A prospective observational study was conducted in the oculoplastic ORs of three surgeons across three tertiary care institutions. Data were collected from both minor and main subspecialty ORs. Variables collected included procedure type, surgery duration, anesthesia, procedural waste weight, and the quantity of opened but unused instruments and materials.

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Results

Five OR days comprising 39 surgical cases were observed, averaging 7.8 cases per day. Procedures included levator resection, blepharoplasty, orbitotomy, evisceration, entropion and ectropion repair, and lesion excision. Topical and local anesthetic were used in all cases, with a total 36.6 mL of lidocaine drawn in excess and subsequently discarded. Average waste production was 1.47 kg per OR day; however, factors including procedure laterality, operative duration, and number of assistants influenced waste generation. Waste production in minor ORs ranged from 0.045 to 0.345 kg per case, whereas the lowest waste production observed in a main OR was 1.625 kg per case. Among opened but unused materials, instruments and cotton-tipped applicators from premade procedural sets represented the greatest contributors to avoidable waste.

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Conclusion

Oculoplastic ORs generate considerable procedural waste, a substantial portion of which arises from opened but unused materials. Potential sustainability interventions include developing smaller procedure-specific instrument trays, limiting routinely opened supplies, optimizing supply preparation practices, and favouring minor OR settings when clinically appropriate. The primary challenge remains balancing sustainability with patient safety and preparedness for unexpected intraoperative events. Further studies evaluating the impact of targeted sustainability interventions on waste reduction and cost savings are warranted.

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Additional Authors

First name	Last name	Base Hospital / Institution
Stuti Misty	Tanya	McGill University
Emma	Youhnovska	McGill University
Carolina	Santos	McGill University
Miguel	Burnier	McGill University
Bryan	Arthurs	McGill University
Christian	El-Hadad	McGill University
Femida	Kherani	University of British Columbia

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