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Quantification of droplet aerosol generation during cataract and pars plana vitrectomy
Free Paper Details
First Author: H.Kaneshayogan UK
Co Author(s): A. Swampillai Z. Liu J. Haywood J. Park E. Herbert I. Sian
Abstract Details
Purpose:
To quantify how much droplet aerosols sized between 0.12-8.00μm are generated during phacoemulsification cataract surgery in human cadaveric eyes, using 2.2mm and 2.75mm incisions, and if aerosol production is reduced by coating the corneal surface with hydroxypropyl methylcellulose (HPMC), and to quantify aerosol production during the different steps of 23-gauge pars plana vitrectomy
Setting:
Taunton and Somerset NHS Foundation Trust, Parkfield Drive, Taunton, United Kingdom
Methods:
A printed optical particle spectrometer (POPS) was used to measure droplet aerosol generation during surgery on human cadaveric eyes for phacoemulsification surgery with either 2.2mm or 2.75mm main incision; both with and without usage of HPMC and during various stages of 23-gauge pars plana vitrectomy(PPV).
Results:
Compared to 2.2mm incisions without HPMC, the mean particle number concentration (MPNC) and particle size generated are much higher with 2.75mm incisions without HPMC. The MPNC and number of droplet aerosols > 1micron in size, reduce when HPMC is used. The maximum measured MPNC without HPMC was 88/cm3 which reduced to 66/ cm3 with HPMC using 2.2mm corneal incisions ( P<0.05). With 2.75mm corneal incisions the maximum MPNC without HPMC was 493/cm3 which reduced to 61/cm3 with HPMC (P<0.05). No droplet aerosol generation was detected during PPV apart from during air infusion through a leaking trocar valve (MPNC of 123/cm3).
Conclusions:
This is the first study to quantify size and number of droplet aerosol production during phacoemulsification and vitrectomy surgery in cadaveric human eyes. The amount of droplet aerosols produced during cataract surgery can be reduced by using a 2.2mm incision and using HPMC to coat the cornea. Droplet aerosols may be generated during vitrectomy surgery during air infusion, in the setting of a leaking trocar valve
Financial Disclosure:
