Lack of Virus Transmission by the Excimer Laser Plume

Risk of Virus Contamination Through Surgical Smoke During Minimally Invasive Surgery: A Systematic Review of the Literature on a Neglected Issue Revived in the COVID-19 Pandemic Era

“…Fig. 1 summarizes the literature review process, which allowed the identification of 24 papers, including 14 clinical studies [14][15][16][17][18][19][20][21][22][23][24][25][26][27], eight preclinical studies [28][29][30][31][32][33][34][35], and two papers reporting both clinical and preclinical data [36,37].…”

“…Again, the majority of the preclinical studies were focused on HPVs and bovine papillomaviruses, with conflicting results. Specifically, some studies evaluating the presence of viral DNA in the surgical smoke after laser treatments of infected cell cultures reconfirmed the presence of the virus Cool vapors and aerosols produced by several common surgical power instruments and hot smoke plumes generated with electrocautery on known HIV-1 inoculated blood were gently bubbled through sterile viral culture media`H IV-1-positive cultured cells generated by the utilization of the 4 different surgical instruments No infectious HIV-1 was detected in aerosols generated by electrocautery or with a manual wound irrigation HIV-1 was cultured from cool aerosols and vapors generated by a 30 000 RPM spinning router tip, an instrument similar to the Midas Rex and the Stryker oscillating bone saw Hagen (1997) [33] Experimental study…”

“…Concerning the studies investigating other viruses, cell cultures infected with different viruses (human immunodeficiency virus [HIV], pseudorabies virus, varicella-zoster virus, and oral poliovirus) have been treated with different lasers to identify the ability of the byproducts to generate infected positive cultured cells, mostly demonstrating negative results [32][33][34][35].…”

Update on contraindications for laser-assisted in situ keratomileusis and photorefractive keratectomy

“…In a porcine model, Hagen et al [40] used an excimer laser to ablate a virus-infected tissue culture plate while an uninfected tissue culture plate was placed in an inverted position over the infected plate. There has been a theoretical concern regarding viral transmission in the plumes of the excimer laser as corneal tissue is vaporized, but the risk of this is unknown.…”

Refractive surgical practices in persons with human immunodeficiency virus positivity or acquired immune deficiency syndrome

“…There are few experimental studies in the literature that evaluated the theoretic possibility of pathogenic virus transmission during excimer laser treatment of corneal tissue. Hagen et al 13 used an excimer laser to apply pulses to a tissue culture plate infected with pseudorabies virus (a virus similar in structure and life cycle to HIV) and studied the transmissibility to an uninfected tissue culture plate placed over the infected plate. The experiment, repeated 20 times, showed that the uninfected plate remained uninfected after 600 laser pulses were applied and concluded that an HIV-infected patient is unlikely to pose a health hazard to the surgeon.…”