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Aerosol generation through pars plana vitrectomy.

Hasan Naveed^1,2, Fong May Chew¹, Hanbin Lee¹

¹Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.

The British Journal of Ophthalmology

|October 15, 2020

Summary

This summary is machine-generated.

Pars plana vitrectomy (PPV) using 23-gauge and 25-gauge setups does not generate significant aerosols. This study found no aerosol generation during PPV or fluid-air exchange, indicating it is not an aerosol-generating procedure (AGP).

Keywords:

Infection Microbiology Vitreous

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Area of Science:

Ophthalmology
Surgical Innovation
Infection Control

Background:

Pars plana vitrectomy (PPV) is a common ophthalmic surgical procedure.
Understanding if PPV is an aerosol-generating procedure (AGP) is crucial for infection control protocols.
Previous studies have not definitively established the aerosol-generating potential of PPV.

Purpose of the Study:

To determine if pars plana vitrectomy (PPV) constitutes an aerosol-generating procedure (AGP).
To quantify aerosol particle generation during different stages of PPV.
To compare aerosol generation between 23-gauge and 25-gauge PPV setups.

Main Methods:

An ex vivo porcine eye model was utilized with 10 eyes.
An optical particle counter measured particles ≤10 μm in six channels during PPV.
Aerosol counts were assessed during pre-PPV baseline, PPV, fluid-air exchange (FAX), and venting with 23-gauge and 25-gauge setups.

Main Results:

No significant difference in aerosol generation was observed between pre-PPV and PPV/FAX for both 23-gauge and 25-gauge setups.
Flute venting with 23-gauge PPV significantly reduced aerosols ≤1 μm.
Chimney venting with 25-gauge PPV did not show a significant difference in aerosols ≤1 μm.

Conclusions:

Pars plana vitrectomy (PPV) with 23-gauge and 25-gauge setups does not generate aerosols ≤10 μm.
The procedure and its associated steps are not considered aerosol-generating procedures (AGPs).
Specific venting techniques, like flute venting, may further reduce particle counts.