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Risk Assessment of Aerosol Generation During Vitreoretinal Surgery Using High Speed Imaging Amidst the COVID-19 Pandemic.
Jayadev, Chaitra; Mochi Basavaraj, Thirumalesh; Pandey, Khushboo; Pinto, Roven; Pandey, Shashi Prabha; Basu, Saptarshi; Roy, Abhijit Sinha; Shetty, Rohit.
  • Jayadev C; Vitreoretina Department, Narayana Nethralaya Eye Institute, Bangalore, India.
  • Mochi Basavaraj T; Vitreoretina Department, Narayana Nethralaya Eye Institute, Bangalore, India.
  • Pandey K; Department of Mechanical Engineering, Indian Institute of Science, Bangalore, India.
  • Pinto R; Department of Mechanical Engineering, Indian Institute of Science, Bangalore, India.
  • Pandey SP; Department of Mechanical Engineering, Indian Institute of Science, Bangalore, India.
  • Basu S; Department of Mechanical Engineering, Indian Institute of Science, Bangalore, India.
  • Roy AS; Imaging, Biomechanics and Mathematical Modeling solutions, Narayana Nethralaya Foundation, Bangalore, India.
  • Shetty R; Vitreoretina Department, Narayana Nethralaya Eye Institute, Bangalore, India.
Transl Vis Sci Technol ; 10(12): 17, 2021 10 04.
Article in English | MEDLINE | ID: covidwho-1467777
ABSTRACT

Purpose:

The purpose of this study was to discuss the propensity of aerosol and droplet generation during vitreoretinal surgery using high speed imaging amidst the coronavirus disease 2019 (COVID-19) pandemic.

Methods:

In an experimental set up, various steps of vitreoretinal surgery were performed on enucleated goat eyes. The main outcome measures were visualization, quantification of size, and calculation of aerosol spread.

Results:

During intravitreal injection, insertion of cannulas, lensectomy, and vitrectomy with both 23 and 25-gauge instruments, with either valved or nonvalved cannulas, aerosols were not visualized which was confirmed on imaging. Although there was no aerosol generation during active fluid air exchange (FAE), there was bubbling and aerosol generation at the exit port of the handle during passive FAE. Under higher air pressure, with reused valved and fresh nonvalved cannulas, aerosol generation showed a trajectory 0.4 to 0.67 m with droplet size of 200 microns. Whereas removing cannulas or suturing under active air infusion (35 mm Hg and above) aerosols were noted.

Conclusions:

Based on the above experiments, we can formulate guidelines for safe vitrectomy during COVID-19. Some recommendations include the use of valved cannulas, avoiding passive FAE or to direct the exit port away from the surgeon and assistant, and to maintain the air pressure less than or equal to 30 mm Hg. Translational Relevance In the setting of the COVID-19 pandemic, the risk from virus laden aerosols, as determined using an experimental setup, appears to be low for commonly performed vitreoretinal surgical procedures.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Vitreoretinal Surgery / COVID-19 Type of study: Prognostic study Limits: Humans Language: English Journal: Transl Vis Sci Technol Year: 2021 Document Type: Article Affiliation country: Tvst.10.12.17

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vitreoretinal Surgery / COVID-19 Type of study: Prognostic study Limits: Humans Language: English Journal: Transl Vis Sci Technol Year: 2021 Document Type: Article Affiliation country: Tvst.10.12.17