Purpose To assess whether pars plana vitrectomy (PPV) is an aerosol-generating procedure (AGP) in an ex vivo experimental model.
Methods In this ex vivo study on 10 porcine eyes, optical particle counter was used to measure particles ≤10 μm using cumulative mode in the six in-built channels: 0.3 μm, 0.5 μm, 1 μm, 2.5 μm, 5 μm and 10 μm aerosols during PPV. Two parts of the study were as follows: (1) to assess the pre-experimental baseline aerosol count in the theatre environment where there are dynamic changes in temperature and humidity and (2) to measure aerosol generation with 23-gauge and 25-gauge set-up. For each porcine eye, five measurements were taken for each consecutive step in the experiment including pre-PPV, during PPV, fluid–air exchange (FAX) and venting using a flute with 23-gauge set-up and a chimney with 25-gauge set-up. Therefore, a total of 200 measurements were recorded.
Results With 23-gauge and 25-gauge PPV, there was no significant difference in aerosol generation in all six channels comparing pre-PPV versus PPV or pre-PPV versus FAX. Venting using flute with 23-gauge PPV showed significant reduction of aerosol ≤1 μm. Air venting using chimney with 25-gauge set-up showed no significant difference in aerosol of ≤1 μm. For cumulative aerosol counts of all particles measuring ≤5 μm, compared with pre-PPV, PPV or FAX, flute venting in 23-gauge set-up showed significant reduction unlike the same comparison for chimney venting in 25-gauge set-up.
Conclusion PPV and its associate steps do not generate aerosols ≤10 μm with 23-gauge and 25-gauge set-ups.
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HN, MFC, HL, EH and MAN contributed equally to this project.
Contributors HN, MFC, HL, EH and MAN: data collection, analysis, manuscript drafting and final approval.
Funding The project was funded by Brighton and Sussex University Hospitals NHS Trust Charity (Charity no.1050864) through the donations received for research related to COVID-19. There is no grant award number.
Competing interests MAN: research grants from Alcon Laboratories, USA; European Society of Cataract & Refractive Surgery; Johnson & Johnson, USA; NuVision Biotherapies, UK; Rayner Intraocular lenses, UK. Lecture fees from Alcon Laboratories, USA. Consultant to Hoya. Travel grant from Alcon Laboratories, USA & Bausch & Lomb, USA.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article.