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Quantification of Aerosol Generation During Cataract Surgery.

PURPOSE
To determine whether phacoemulsification cataract surgery is an aerosol-generating medical procedure (AGMP) and therefore, to help determine the personal protective equipment required by healthcare providers in the era of the COVID-19 pandemic, as COVID-19 can be transmitted via aerosolization during AGMPs.


SETTING
Laboratory DESIGN:: In this laboratory-based simulation, phacoemulsification cataract surgery was performed on porcine eyes. At a fixed distance, a DustTrak DRX Aerosol Monitor Model 8534 (DustTrak) was positioned to quantify particle generation during surgery. Experiments were run in triplicate for two wound sizes, 2.4 and 2.75mm. Positive controls were established by measuring particle generation from an aerosolizing spray-bottle. Negative controls were established while the phacoemulsification machine was not running.


METHODS
The DustTrak was used to measure particulate matter (PM) mass fractions for each of three particle sizes, PM1, PM2.5, and PM4 (in microns), every 2 seconds during surgery and for one minute after. The main outcome measure was an increase in the mass fraction of aerosolized particles of various sizes.


RESULTS
There was no significant aerosolization of particles during cataract surgery for both the 2.4 and 2.75mm wound sizes.


CONCLUSIONS
Phacoemulsification cataract surgery was not found to be an AGMP. In the midst of the COVID-19 pandemic, ophthalmologists can continue to use droplet precautions while performing this surgery.