Your browser doesn't support javascript.
Microdroplet and spatter contamination during phacoemulsification cataract surgery in the era of COVID-19.
McGhee, Charles N J; Dean, Simon; Freundlich, Simone E N; Gokul, Akilesh; Ziaei, Mohammed; Patel, Dipika V; Niederer, Rachael L; Danesh-Meyer, Helen V.
  • McGhee CNJ; Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
  • Dean S; Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.
  • Freundlich SEN; Eye Institute, 123 Remuera Road, Auckland, New Zealand.
  • Gokul A; Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
  • Ziaei M; Eye Institute, 123 Remuera Road, Auckland, New Zealand.
  • Patel DV; Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
  • Niederer RL; Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.
  • Danesh-Meyer HV; Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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 OUTCOME

MEASURES:

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.
Subject(s)
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

Similar

MEDLINE

...
LILACS

LIS


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