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Microdroplet and spatter contamination during phacoemulsification cataract surgery in the era of COVID-19

Charles N J McGhee1,2,3, Simon Dean1,3, Simone E N Freundlich1,2

  • 1Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

Clinical & Experimental Ophthalmology
|September 19, 2020
PubMed
Abstract

Insights

Phacoemulsification cataract surgery can generate spatter up to 16 cm, posing a risk to surgical teams. This pilot study suggests standard personal protective equipment is adequate for cataract surgery during the COVID-19 pandemic.

Area of Science:

  • Ophthalmology
  • Surgical Safety
  • Infectious Disease Control

Background:

  • Phacoemulsification cataract surgery is a common procedure with potential for droplet transmission of SARS-CoV-2.
  • Understanding contamination risks is crucial for protecting healthcare professionals.

Purpose of the Study:

  • To determine the risk of contamination during phacoemulsification cataract surgery in the COVID-19 era.
  • To assess the extent of microdroplet and spatter generation during the procedure.

Main Methods:

  • A pilot study using enucleated porcine eyes simulated phacoemulsification cataract surgery.
  • Fluorescein dye in irrigation fluid visualized microdroplets and spatter.
  • Quantitative image analysis documented contamination spread.

Main Results:

  • Spatter contamination was generally limited (<10 cm) when instruments were inside the eye.
  • Insertion/removal of the needle and irrigation generated spatter on gloves and gowns, extending over 16 cm.
  • A torn irrigation sleeve exacerbated spatter, but contamination remained below the neckline.

Conclusions:

  • Phacoemulsification cataract surgery generates microdroplets and spatter.
  • Current evidence supports the use of standard personal protective equipment for cataract surgery.
  • Further research on SARS-CoV-2 transmission via ocular fluids is needed.
Keywords:
Covid-19SARS-CoV-2aerosol-generating proceduremicrodroplet generating procedurephacoemulsification cataract surgery

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