Wong Jasper Ka Wai, Kwok Jeremy Sze Wai John, Chan Jonathan Cheuk Hung, Shih Kendrick Co, Qin Renyuan, Lau Denvid, Lai Jimmy Shiu Ming
Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong.
Department of Architecture and Civil Engineering, College of Engineering, City University of Hong Kong, Hong Kong.
Clin Ophthalmol. 2021 Jan 27;15:307-313. doi: 10.2147/OPTH.S294778. eCollection 2021.
Concerns had been raised for the potential hazard of SARS-CoV-2 transmissions via aerosols and fluid droplets during cataract surgeries amid the COVID-19 pandemic. This study aims to evaluate the rate of visible aerosol generation and fluid spillage from surgical wounds during phacoemulsification in human subjects.
This is a prospective consecutive interventional case series. High-resolution video captures of 30 consecutive uncomplicated phacoemulsification surgeries, performed by 3 board-certified specialists in ophthalmology, were assessed by 2 independent and masked investigators for intraoperative aerosolization and fluid spillage. Water-contact indicator tape was mounted on the base of the operating microscope, around the objective lens, to detect any fluid contact.
No visible intraoperative aerosolization was detected in any of the cases, irrespective of different surgical practices among the surgeons with regard to wound size and position, lens fragmentation technique, power settings and means of ocular lubrication, or the different densities of cataract encountered. Large droplets spillage was noted from the paracentesis wounds in 70% of the cases. For all cases where fluid spill was detected on video, there was no fluid contact detected on the water-contact indicator tape.
Visible aerosolization was not detected during phacoemulsification in our case series. Although the rate of fluid spillage was high, the lack of detectable contact with the indicator tape suggested that these large droplets posed no significant infectious risks to members of the surgical team.
在新冠疫情期间，人们对白内障手术过程中严重急性呼吸综合征冠状病毒2（SARS-CoV-2）通过气溶胶和飞沫传播的潜在风险表示担忧。本研究旨在评估人类受试者在超声乳化手术过程中手术伤口产生可见气溶胶和液体溢出的发生率。
这是一个前瞻性连续干预病例系列。由3名眼科委员会认证专家进行的30例连续无并发症的超声乳化手术的高分辨率视频记录，由2名独立且不知情的研究者评估术中气溶胶形成情况和液体溢出情况。将水接触指示带安装在手术显微镜底座围绕物镜的位置，以检测是否有液体接触。
在所有病例中均未检测到可见的术中气溶胶形成，无论外科医生在伤口大小和位置、晶状体破碎技术、功率设置和眼部润滑方式等方面的手术操作如何，也无论所遇到的白内障密度如何。70%的病例中穿刺伤口有大液滴溢出。在视频中检测到有液体溢出的所有病例中，水接触指示带上均未检测到液体接触。
在我们的病例系列中，超声乳化手术过程中未检测到可见的气溶胶形成。尽管液体溢出率很高，但指示带上未检测到接触表明这些大液滴对手术团队成员没有显著的感染风险。
