Quantification of aerosol generation during cataract surgery

Noureddin, Gelareh S; Iovieno, Alfonso; Eslami, Maryam; Weaver, Travers; Meadows, Howard; Yeung, Sonia N.

doi:10.1097/j.jcrs.0000000000000530

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…This and the other studies of potential COVID-19 transmission during phacoemulsification provide persuasive evidence that cataract surgery is a relatively clean procedure with a low risk for microbial cross-contamination. [16][17][18][19][20][21] This would explain why strict enforcement of compulsory bans on reusing most ophthalmic surgical supplies and devices failed to produce a measurable benefit, while generating massive amounts of waste. 35,36 These registry studies do not scientifically establish that reusing ophthalmic surgical products is always safe and should be routinely adopted.…”

Section: Evidence and Opportunitymentioning

confidence: 99%

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Tackling the challenge of needless surgical waste in ophthalmology

Chang

2023

J Cataract Refract Surg

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Section: Evidence and Opportunitymentioning

confidence: 99%

“…However, multiple studies prompted by the COVID-19 pandemic concluded that the risk for crosscontamination from aerosolized pathogens during phacoemulsification is exceedingly remote. [16][17][18][19][20][21] This underscores the need for more research to ascertain which universal infection control policies do or do not lower the endophthalmitis risk.…”

mentioning

confidence: 99%

Tackling the challenge of needless surgical waste in ophthalmology

Chang

2023

J Cataract Refract Surg

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“…Fortunately, the two primary approaches for refractive surgery, corneal and lens-based, do not appear to be high risk procedures based on the lack of particle aerosolization. 7,8 This is also great news for our field because we can continue to offer refractive surgery options knowing that the risk of transmission through surgery appears to be extremely low.…”

Section: E D I T O R I a Lmentioning

confidence: 99%

The State of Refractive Surgery: 2021 and Beyond

Randleman¹

2021

J Refract Surg

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Phacoemulsification and nucleic acid-enriched aerosol: considerations from an eye model of cataract simulation

Cacciamani

Scarinci

Bruno

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose The purpose of this study is to investigate whether phacoemulsification can generate aerosolized single-stranded RNA (ssRNA) and retain sequence integrity using an artificial eye model for experimental cataract surgery. Methods A simulation of cataract surgery was performed using an anterior chamber eye model filled with an ssRNA probe at different scalar dilutions (kanamycin positive control ssRNA). A plastic conical cage was built over the artificial eye surface of the mock-up. A total of 24 tests (twice reproduced) were performed, and five nitrocellulose strips were placed 15 cm from the artificial surface of the mock-up and used to collect aerosol particles, from each experiment. Phaco-activity was mimicked using a phacoemulsification equipped with a 2.75-mm tip, and strips were removed at the end of the procedure. RNA extraction, reverse transcription, and agarose gel electrophoresis were performed and compared. Results Strips collected aerosol droplets enriched with ssRNA, mainly at the higher concentrations tested, compared to related untouched standard solutions. Complementary DNA (cDNA) synthesis confirmed the presence of intact ssRNA fragments. As observed from densitometric analysis of resolved RNA in extracted samples and cDNA bands after retro-transcription, lower concentrations of ssRNA were also detected. Conclusions As the main output of the study, the phaco-generated aerosol can deliver an intact ssRNA sequence. Since the aerosol can potentially reach the operator’s face, any biological agent (virus/bacteria) potentially inside the anterior chamber of a patient undergoing cataract surgery, eventually escaping from biomolecular checks, can be potentially infective for operators. The data reported herein suggest that collective versus individual protective countermeasures should always be encouraged in ocular surgery and should not be restricted to coronavirus disease emergencies.

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Quantification of aerosol generation during cataract surgery

Abstract: Phacoemulsification cataract surgery was not found to be an aerosol-generating medical procedure.

Cited by 5 publications

References 11 publications

Tackling the challenge of needless surgical waste in ophthalmology

Tackling the challenge of needless surgical waste in ophthalmology

The State of Refractive Surgery: 2021 and Beyond

Phacoemulsification and nucleic acid-enriched aerosol: considerations from an eye model of cataract simulation

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