Scoping Review of Cataract Surgery Sterility: Data Gaps Linking Sustainability and Clinical Impact.

Authors

Zorana Vujadinovic, Abdullah Al-Ani, Brooklyn Rawlyk, Robert T Moore, Michael T Kryshtalskyj, Tara Klassen, Caitlin McClurg, Patrick Gooi, Mili Roy, Paul Huang

Published in

Journal of cataract and refractive surgery. Sep 09, 2026. Epub Sep 09, 2026.

Abstract

Sterility practices in the cataract operating room (OR) are adopted to reduce the risk of complications. However, their clinical effectiveness remains uncertain, while their contribution to OR waste and carbon emissions is well established.
To conduct a scoping review examining the global diversity, clinical evidence, and environmental impact of antiseptics, drapes, gloves, masks, and gowns in adult cataract surgery.
Reports in the English language on perioperative sterility practice patterns, clinical efficacy related to infection or inflammation, or environmental impacts of adult cataract surgery without time restrictions.
Searches were conducted across Embase, MEDLINE, Scopus, Web of Science, Cochrane Library, CINAHL, and ProQuest Dissertations & Theses Global.
Two reviewers independently screened records, and one investigator extracted data using a pilot-tested form.
Of 3,360 records screened, 148 articles met the inclusion criteria. There were 83 (56%) experimental studies, 10 (7%) case reports/series, 24 (16%) surveys, 25 (17%) opinion-based articles or guidelines, and 6 (4%) economic/environmental evaluations. A meta-analysis of 1,608 eyes revealed that conjunctival povidone-iodine significantly reduced bacterial load on the ocular surface, potentially lowering the risk of endophthalmitis. Mask use was associated with a possible protective effect. In contrast, draping, gloving, and gowning were primarily discussed in opinion-based literature, comprising 40%, 38%, and 46% of reports on each practice, respectively.
Conjunctival povidone-iodine and masks are supported by relatively more substantial evidence in cataract surgery. In contrast, drapes, gloves, and gowns lack robust clinical data and may contribute to avoidable environmental burden.

PMID:
42715239
Bibliographic data and abstract were imported from PubMed on 10 Sep 2026.

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