Microdroplet and spatter contamination during phacoemulsification cataract surgery in the era of COVID-19
© 2020 Royal Australian and New Zealand College of Ophthalmologists..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Clinical & experimental ophthalmology - 48(2020), 9 vom: 30. Dez., Seite 1168-1174 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
McGhee, Charles N J [VerfasserIn] |
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| Links: |
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| Themen: |
Aerosol-generating procedure |
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| Anmerkungen: |
Date Completed 30.12.2020 Date Revised 16.07.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ceo.13861 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM315208279 |
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| 100 | 1 | |a McGhee, Charles N J |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Microdroplet and spatter contamination during phacoemulsification cataract surgery in the era of COVID-19 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 Royal Australian and New Zealand College of Ophthalmologists. | ||
| 520 | |a IMPORTANCE: Determine phacoemulsification cataract surgery risk in a Covid-19 era | ||
| 520 | |a 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 | ||
| 520 | |a DESIGN: Pilot study involving phacoemulsification cataract surgery on enucleated porcine eyes by experienced ophthalmologists in an ophthalmic operating theatre | ||
| 520 | |a PARTICIPANTS: Two ophthalmic surgical teams | ||
| 520 | |a 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 | ||
| 520 | |a MAIN OUTCOME MEASURES: Microdroplet and spatter contamination from cataract phacoemulsification | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a microdroplet generating procedure | |
| 650 | 4 | |a phacoemulsification cataract surgery | |
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| 700 | 1 | |a Ziaei, Mohammed |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Dipika V |e verfasserin |4 aut | |
| 700 | 1 | |a Niederer, Rachael L |e verfasserin |4 aut | |
| 700 | 1 | |a Danesh-Meyer, Helen V |e verfasserin |4 aut | |
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