Aerosolization and Fluid Spillage During Phacoemulsification in Human Subjects

Area of Science:

• Ophthalmology
• Surgical Safety
• Infectious Disease Transmission

Background:

• Concerns regarding SARS-CoV-2 transmission via aerosols and droplets during cataract surgery during the COVID-19 pandemic.
• Need to evaluate risks associated with phacoemulsification procedures.

Purpose of the Study:

• To assess the incidence of visible aerosol generation during phacoemulsification.
• To quantify fluid spillage from surgical wounds during the procedure.

Main Methods:

• Prospective, consecutive interventional case series of 30 phacoemulsification surgeries.
• High-resolution video recording and masked investigator assessment for aerosols and fluid spillage.
• Use of water-contact indicator tape to detect fluid contact with microscope objective lens.

Main Results:

• No visible intraoperative aerosolization was detected in any of the 30 cases.
• Large droplet spillage from paracentesis wounds occurred in 70% of surgeries.
• No fluid contact was detected on the indicator tape, despite observed fluid spillage.

Conclusions:

• Phacoemulsification cataract surgery did not generate detectable visible aerosols.
• High rates of fluid spillage were observed, but did not appear to pose a significant infectious risk.
• The study suggests a low risk of SARS-CoV-2 transmission via aerosols during this procedure.