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Viral contamination during sequential phacoemulsification surgeries in an experimental model
Roberto Pinto Coelho1, Tatiana Vannucci Garcia, Jayter Silva Paula
1Cataract Service, Department of Ophthalmology and Otorhinolaryngology, Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto, Brazil. robertopintocoelho@uol.com.br
Purpose:
To determine the incidence of Piry virus contamination among surgical instruments used with disposable accessories for phacoemulsification during sequential surgeries.
Methods:
An experimental model was created with 4 pigs' eyes that were contaminated with Piry virus and 4 pigs' eyes that were not contaminated. Phacoemulsification was performed on the eyes, alternating between the contaminated and non-contaminated eyes. From one surgery to another, the operating fields, gloves, scalpel, tweezers, needles, syringes, tips and bag collector from the phacoemulsification machine were exchanged; only the hand piece and the irrigation and aspiration systems were maintained.
Results:
In the collector bag, three samples from the contaminated eyes (3/4) were positive, and two samples from the non-contaminated (2/4) eyes were also positive; at the tip, one sample from the contaminated eyes (1/4) and two samples of the non-contaminated eyes (2/4) yielded positive results. In the irrigation system, one sample from a non-contaminated eye (1/4) was positive, and in the aspiration system, two samples from contaminated eyes (2/4) and two samples from non-contaminated eyes (2/4) were positive. In the gloves, the samples were positive in two samples from the non-contaminated eyes (2/4) and in two samples from the contaminated eyes (2/4). In the scalpel samples, three contaminated eyes (3/4) and none of the non-contaminated eyes (0/4) were positive; finally, two samples from the anterior chambers of the non-contaminated eyes gathered after surgery were positive.
Conclusions:
In two non-contaminated eyes, the presence of genetic material was detected after phacoemulsification surgery, demonstrating that the transmission of the genetic material of the Piry virus occurred at some point during the surgery on these non-contaminated eyes when the hand piece and irrigation and aspiration systems were reused between surgeries.
Insights
Piry virus genetic material was detected in non-contaminated eyes after phacoemulsification surgery, indicating cross-contamination via reused surgical equipment. This highlights potential risks during sequential cataract surgeries.
Area of Science:
- Ophthalmology
- Virology
- Surgical Safety
Background:
- Phacoemulsification is a common cataract surgery technique.
- Disposable accessories are used to minimize contamination risks.
- The potential for viral transmission via surgical instruments requires investigation.
Purpose of the Study:
- To assess Piry virus contamination on surgical instruments during sequential phacoemulsification procedures.
- To determine the incidence of viral transmission to non-contaminated eyes.
Main Methods:
- An experimental model using pigs' eyes, with alternating contamination and non-contamination.
- Phacoemulsification performed on eyes, with exchange of most accessories between surgeries.
- Maintenance of the hand piece and irrigation/aspiration systems between procedures.
Main Results:
- Piry virus genetic material was found in collector bags, tips, irrigation/aspiration systems, gloves, and anterior chambers.
- Contamination was detected in both initially contaminated and non-contaminated eyes.
- Scalpel samples showed contamination in 3/4 contaminated eyes but 0/4 non-contaminated eyes.
Conclusions:
- Viral genetic material was detected in non-contaminated eyes post-surgery.
- This demonstrates Piry virus transmission during sequential surgeries.
- Reuse of hand piece and irrigation/aspiration systems likely facilitated viral spread.
