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Aerosol generation through pars plana vitrectomy
  1. Hasan Naveed1,2,
  2. Fong May Chew1,
  3. Hanbin Lee1,
  4. Edward Hughes1,
  5. Mayank A Nanavaty1
  1. 1 Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  2. 2 Brighton and Sussex Medical School, Brighton, UK
  1. Correspondence to Mayank A Nanavaty, Sussex Eye Hospital, Brighton & Sussex University Hospitals NHS Trust, Eastern Road, Brighton BN2 5BF, UK; mayank.nanavaty{at}nhs.net

Abstract

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.

  • Microbiology
  • Vitreous
  • Infection
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Footnotes

  • 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.

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