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Flammability of Ocular Surface Lubricants
Akash Gupta1, Lucy I Mudie, Michael T Yen
1Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, U.S.A.
Ophthalmic lubricants generally pose a low fire risk. However, some can conduct electricity with monopolar cautery or act as fuel with high-temperature cautery, increasing surgical fire hazards.
Area of Science:
- Ophthalmology
- Surgical Safety
Background:
- Surgical fires are a significant risk in oculofacial surgery.
- Ocular surface lubricants may contribute to operating room fires.
Purpose of the Study:
- To experimentally analyze the flammability of ophthalmic lubricants.
- To assess lubricant reactions to common surgical ignition sources with and without supplemental oxygen.
Main Methods:
- Tested 9 ophthalmic lubricants against 4 ignition sources (lighter, monopolar cautery, bipolar cautery, high-temperature cautery).
- Evaluated lubricant responses in room air and with 100% oxygen delivery via nasal cannula.
Main Results:
- Four of nine lubricants showed reactions.
- Petrolatum and neomycin-polysporin-bacitracin-hydrocortisone ointments produced smoke with high-temperature cautery (without oxygen).
- Carboxymethylcellulose drops and lidocaine jelly conducted and sparked with monopolar cautery under both oxygen conditions.
Conclusions:
- The overall fire hazard from ocular lubricants is low.
- Some lubricants increase electrical burn risk with monopolar cautery.
- Certain lubricants may act as fuel with high-temperature cautery; bipolar cautery showed no increased risk.
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