Related Experiment Video
Updated: Dec 8, 2025

Nasal Brushing Sampling and Processing Using Digital High Speed Ciliary Videomicroscopy – Adaptation for the COVID-19 Pandemic
Published on: November 7, 2020
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.
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.
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.
More Related Videos
05:19Author Spotlight: Unraveling the Molecular Mechanisms in PCO and Fibrosis Following Cataract Surgery
Published on: December 1, 2023
04:59Author Spotlight: Enhancing Visual Outcomes in Cataract Surgery: A Novel Technique to Prevent Posterior Capsular Opacification Through IOL Rotation
Published on: July 7, 2023
Related Concept Videos
Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Suctioning the Nasopharyngeal Airway
Equipment Required
Hand hygiene
Hand washing...