LABORATORY SCIENCE

Aerosol generation through phacoemulsification

Lee, Hanbin MBBS, BSc; Naveed, Hasan MBBS, BSc(Hons); Ashena, Zahra FRCOphth; Nanavaty, Mayank A. MBBS, DO, FRCOphth, PhD

Author Information

From the Sussex Eye Hospital, Brighton & Sussex University Hospitals NHS Trust (Lee, Naveed, Ashena, Nanavaty), and Brighton & Sussex Medical School, University of Sussex (Naveed, Nanavaty), Brighton, United Kingdom.

All authors contributed equally to this work.

Corresponding author: Mayank Nanavaty, MBBS, DO, FRCOphth, PhD, Sussex Eye Hospital, Brighton & Sussex University Hospitals NHS Trust, Eastern Road, Brighton, BN2 5BF, United Kingdom. Email: [email protected]

Funded by Brighton & Sussex University Hospitals NHS Trust Charity (Charity no. 1050864) through the donations received for research related to COVID-19.

Disclosures: Dr. Nanavaty received research grants from Alcon Laboratories, European Society of Cataract and Refractive Surgeons, Johnson & Johnson Vision, NuVision Biotherapies, and Rayner Intraocular Lenses; lecture fees from Alcon Laboratories; is a consultant to Hoya, and received travel grants from Alcon Laboratories and Bausch & Lomb, Inc., outside the submitted work. None of the other authors has a financial or proprietary interest in any material or method mentioned.

Nidhi Desai, BMBS; BSc, an approved fit-tester for FFP3 masks at Brighton & Sussex University Hospitals NHS Trust, Brighton, United Kingdom, helped with the fit-testing hood experiment.

Journal of Cataract & Refractive Surgery 46(9):p 1290-1296, September 2020. | DOI: 10.1097/j.jcrs.0000000000000288

Purpose:

To evaluate whether phacoemulsification is an aerosol-generating procedure in an ex vivo experimental model.

Setting:

Sussex Eye Hospital, Brighton, United Kingdom.

Design:

Experimental study.

Methods:

In this ex vivo study on 15 porcine eyes, an optical particle counter was used to measure particles of 10 µm and less using the cumulative mode based on the 6 in-built channel sizes. The 2 parts of the study were to: (1) assess the efficacy of the particle counter in the theater environment where there are dynamic changes in temperature and humidity; and (2) to measure aerosol generation with 3 phacoemulsification settings: (i) continuous power with 80% longitudinal (5 eyes); (ii) continuous power with 100% torsional (5 eyes); and (iii) continuous power with 80% longitudinal with application of hydroxypropyl methylcellulose (HPMC) on the ocular surface (5 eyes). Five measurements were taken prephacoemulsification and 5 during phacoemulsification per eye therefore totaling 75 measurements.

Results:

Maximum aerosols were captured when the counter faced the aerosol source. There was no significant difference in aerosol generation of all sizes during each phacoemulsification setting with torsional, longitudinal, and longitudinal with HPMC (P > .01). Combining data of all 3 phacoemulsification settings (150 measurements from 15 eyes), there was no significant difference comparing prephacoemulsification and during phacoemulsification for aerosols of 5 µm or less (1455 vs 1363.85, P = .60), more than 5 to 10 μm (1.5 vs 1.03, P = .43), and of 10 µm or less (1209 vs 1131.55, P = .60).

Conclusions:

Phacoemulsification did not generate aerosols of 10 μm or less with continuous power using 80% longitudinal, 100% torsional, and 80% longitudinal setting with HPMC on the surface.

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