Microplastics exposures in cataract surgery and potential clinical concerns

Area of Science:

• Ophthalmology
• Environmental Science
• Materials Science

Background:

• Microplastic (MP) exposure is a growing global health concern.
• Cataract surgery, the most common ocular surgery, utilizes various plastic instruments, raising questions about potential MP contamination.
• Understanding MP presence in ocular tissues and fluids is crucial for patient safety.

Purpose of the Study:

• To investigate the presence and characteristics of microplastics (MPs) in surgical devices, intraocular fluids, and cataractous crystalline lenses during cataract surgery.
• To identify the types and sizes of MPs found.
• To explore potential correlations between patient health conditions and MP levels.

Main Methods:

• Collection of surgical solutions, devices, ocular inflow/outflow fluids, cataractous lenses, and operating room air samples from cataract surgery patients.
• Analysis of MP presence and characteristics using Raman spectroscopy.
• Assessment of MP surface morphologies via scanning electron microscopy with energy dispersive spectroscopy.

Main Results:

• No MPs were detected in irrigation saline, balanced salt solution (BSS), or ophthalmic viscosurgical devices (OVD).
• Low levels of MPs were found in ocular inflow fluids and operating room air.
• Significantly higher MP concentrations were observed in intraocular outflow fluids and cataractous crystalline lenses, with diverse polymer types identified.
• Patients with prior ocular diseases or diabetes showed higher MP concentrations.

Conclusions:

• Microplastics can enter the eyeball during cataract surgery, potentially originating from surgical instruments or the operating room environment.
• Substantial intraocular MP contamination appears to exist prior to surgery, rather than solely from external surgical sources.
• The presence of various polymer types in lenses and outflow fluids highlights a significant exposure pathway that warrants further investigation.