Aerosol generation during phacoemulsification in live patient cataract surgery environment

To investigate whether phacoemulsification is an aerosol-generating procedure in a live patient environment.

New Hayesbank Ophthalmology Services, Kent, United Kingdom.

In vivo experimental human eyes study.

Aerosol particle counts sized 0.3 μm or lesser, more than 0.3 to 0.5 μm or lesser, more than 0.5 to 1 μm or lesser, more than 1 to 2.5 μm or lesser, more than 2.5 to 5 μm or lesser, and more than 5 to 10 μm or lesser were measured during elective phacoemulsification surgery of 25 eyes. The baseline particle count in the operating theater was measured on 2 separate days to assess for fluctuation. Then, 5 readings each during prephacoemulsification and phacoemulsification of all eyes were measured. The difference in aerosol generation during prephacoemulsification and phacoemulsification was also measured with the use of the mobile laminar air flow (LAF) machine. Finally, aerosol generation during phacoemulsification was measured using 2% hydroxypropyl methylcellulose (HPMC).

There was no statistically significant difference in measurement of aerosol between the baseline measurements on both days and between each patient's prephacoemulsification and phacoemulsification stages of surgery. The LAF system showed statistically significant reduction in particles size of 0.3 μm or lesser, more than 0.3 to 0.5 μm or lesser, more than 0.5 to 1 μm or lesser, more than 1 to 2.5 μm or lesser, more than 2.5 to 5 μm or lesser, and more than 5 to 10 μm during phacoemulsification compared with that during prephacoemulsification (P value .00 for all particle sizes, t test). The use of 2% HPMC did not show any statistically significant reduction in particle measurements.

Aerosol particles sized less than 10 μm are not produced during phacoemulsification of human crystalline lens in a live patient setting. The use of a mobile LAF machine significantly reduced the number of particles sized 10 μm or lesser within the surgical field.