key: cord-0709473-ff7nn2h1
authors: Plemel, David J.A.; Tong, C. Maya; Chan, Stanley M.
title: Creating aerosolized droplets in phacoemulsification
date: 2020-10-17
journal: Can J Ophthalmol
DOI: 10.1016/j.jcjo.2020.09.013
sha: a98a4b8d7a1a6179024c353f931f4c12cad7c379
doc_id: 709473
cord_uid: ff7nn2h1

nan

Creating aerosolized droplets in phacoemulsification A wetlab was set up using porcine eyes, an artificial anterior chamber maintainer, and an Alcon Infiniti phacoemulsification system (Fort Worth, TX; Fig. A) . Colouring dye was placed in the irrigation fluid for easy identification of droplets on a white paper surface surrounding the eye. During simulated phacoemulsification, droplet/aerosol production occurred when the irrigation ports were in the incision, but not when they were entirely within the anterior chamber. A similar study, using cadaveric eyes and a 2.2 mm phacoemulsification sleeve, also found that no droplet/aerosol was produced when instruments were held entirely within the anterior chamber. 1 Vertical torque on the wound and long incisions increased droplet production. Hydroxypropyl methylcellulose coating the cornea decreased droplet production. 2 With phacoemulsification settings at maximum power and no hydroxypropyl methylcellulose on the cornea, the furthest documented droplet radius was 13.2 cm with a 2.75 mm keratome incision (Fig. B ) versus 1.9 cm with a 2.2 mm keratome incision (Fig. C) . These observations, along with evidence of low transmission risk for coronavirus disease 2019 from the tear film, suggest that phacoemulsification is low risk as an aerosol-generating procedure. 

Addressing the concerns of aerosolization during phacoemulsification due to COVID-19: human cadaveric eye with trypan blue [e-pub ahead of print

Reducing visible aerosol generation during phacoemulsification in the era of Covid-19

The authors have no proprietary or commercial interest in any materials discussed in this article.https://doi.org/10.1016/j.jcjo.2020.09.013 ISSN 0008-4182