Microdroplet and spatter contamination during phacoemulsification cataract surgery in the era of COVID-19.
Clin Exp Ophthalmol
; 48(9): 1168-1174, 2020 12.
Article
in English
| MEDLINE | ID: covidwho-780795
ABSTRACT
IMPORTANCE Determine phacoemulsification cataract surgery risk in a Covid-19 era. BACKGROUND:
SARS-CoV-2 (Covid-19) transmission via microdroplet and aerosol-generating procedures presents risk to medical professionals. As the most common elective surgical procedure performed globally; determining contamination risk from phacoemulsification cataract surgery may guide personal protection equipment use.DESIGN:
Pilot study involving phacoemulsification cataract surgery on enucleated porcine eyes by experienced ophthalmologists in an ophthalmic operating theatre.PARTICIPANTS:
Two ophthalmic surgical teams.METHODS:
Standardized phacoemulsification of porcine eyes by two ophthalmologists accompanied by an assistant. Fluorescein incorporated into phacoemulsification irrigation fluid identifying microdroplets and spatter. Contamination documented using a single-lens reflex camera with a 532 nm narrow bandpass (fluorescein) filter, in-conjunction with a wide-field blue light and flat horizontal laser beam (wavelength 532 nm). Quantitative image analysis using Image-J software. MAIN OUTCOMEMEASURES:
Microdroplet and spatter contamination from cataract phacoemulsification.RESULTS:
With phacoemulsification instruments fully within the eye, spatter contamination was limited to <10 cm. Insertion and removal of the phacoemulsification needle and bimanual irrigation/aspiration, with irrigation active generated spatter on the surgeons' gloves and gown extending to >16 cm below the neckline in surgeon 1 and > 5.5 cm below the neckline of surgeon 2. A small tear in the phacoemulsification irrigation sleeve, presented a worse-case scenario the greatest spatter. No contamination above the surgeons' neckline nor contamination of assistant occurred. CONCLUSIONS AND RELEVANCE Cataract phacoemulsification generates microdroplets and spatter. Until further studies on SARS-CoV-2 transmission via microdroplets or aerosolisation of ocular fluid are reported, this pilot study only supports standard personal protective equipment.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Cataract
/
Equipment Contamination
/
Disease Transmission, Infectious
/
Phacoemulsification
/
SARS-CoV-2
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Clin Exp Ophthalmol
Journal subject:
Ophthalmology
Year:
2020
Document Type:
Article
Affiliation country:
Ceo.13861
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