A wetlab was set up using porcine eyes, an artificial anterior chamber maintainer, and an Alcon Infiniti phacoemulsification system (Fort Worth, TX; Fig. A). Colouring dye was placed in the irrigation fluid for easy identification of droplets on a white paper surface surrounding the eye. During simulated phacoemulsification, droplet/aerosol production occurred when the irrigation ports were in the incision, but not when they were entirely within the anterior chamber. A similar study, using cadaveric eyes and a 2.2 mm phacoemulsification sleeve, also found that no droplet/aerosol was produced when instruments were held entirely within the anterior chamber.
1
Vertical torque on the wound and long incisions increased droplet production. Hydroxypropyl methylcellulose coating the cornea decreased droplet production.- Rai A.S.
- Mele R.
- Rai A.S.
- Braga-Mele R.
Addressing the concerns of aerosolization during phacoemulsification due to COVID-19: human cadaveric eye with trypan blue [e-pub ahead of print].
J Cataract Refract Surg. 2020; (Accessed Sept. 16, 2020)https://doi.org/10.1097/j.jcrs.0000000000000314
2
With phacoemulsification settings at maximum power and no hydroxypropyl methylcellulose on the cornea, the furthest documented droplet radius was 13.2 cm with a 2.75 mm keratome incision (Fig. B) versus 1.9 cm with a 2.2 mm keratome incision (Fig. C). These observations, along with evidence of low transmission risk for coronavirus disease 2019 from the tear film, suggest that phacoemulsification is low risk as an aerosol-generating procedure.- Darcy K.
- Elhaddad O.
- Achiron A.
- et al.
Reducing visible aerosol generation during phacoemulsification in the era of Covid-19 [e-pub ahead of print].
Eye (Lond). 2020; (Accessed August. 7, 2020)https://doi.org/10.1038/s41433-020-1053-3
Footnotes and Disclosure
The authors have no proprietary or commercial interest in any materials discussed in this article.
References
- Addressing the concerns of aerosolization during phacoemulsification due to COVID-19: human cadaveric eye with trypan blue [e-pub ahead of print].J Cataract Refract Surg. 2020; (Accessed Sept. 16, 2020)https://doi.org/10.1097/j.jcrs.0000000000000314
- Reducing visible aerosol generation during phacoemulsification in the era of Covid-19 [e-pub ahead of print].Eye (Lond). 2020; (Accessed August. 7, 2020)https://doi.org/10.1038/s41433-020-1053-3
Article info
Publication history
Published online: October 17, 2020
Accepted:
September 17,
2020
Received in revised form:
September 16,
2020
Received:
July 19,
2020
Identification
Copyright
© 2020 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
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