Eyeworld

16 | EYEWORLD | SEPTEMBER 2021 ASCRS/EYEWORLD JOURNAL CLUB ASCRS NEWS by Hans Andrews, MD, Jordan Comstock, MD, Jennifer Lindsey, MD The preliminary study investigated 5 eyes of 3 patients, while the follow-on study had 20 eyes in 20 patients. The operating room used in this study had positive pressure ventilation and a high-efficien- cy particle filtration system. The study utilized a laminar airflow machine (LAF), which filters 99.995% of particles more than 0.3 mm and im- proves air sterility. A particle counter was used to detect any aerosolized particles by sampling the air over 21 seconds while reporting the cumulative number of particles in six different size categories ranging from <0.3 mm to <10 mm. During each operation, five intermittent measurements were taken before phacoemulsifi- cation and five during phacoemulsification. The preliminary study set out to eval- uate three main variables: (1) the effect of phacoemulsification on particle count, (2) the effect of LAF on particle count, and (3) the effect of OcuCoat (hydroxypropyl methylcellu- lose, Bausch + Lomb), a viscoelastic marketed to reduce aerosolization of particles, on particle count. These variables were tested on three patients. The first patient (one eye only) under- went standard cataract surgery with phacoemul- sification comparing pre-phaco values to during phaco values. The second patient (eyes one and two) utilized the LAF machine for the entirety of the surgery on both eyes. The third patient (eyes one and two) utilized the LAF machine and OcuCoat viscoelastic. The follow-on study evaluated 20 eyes with the use of the LAF machine and standard viscoelastic. Results Baseline aerosol measurements were obtained in the operating room on two separate days, both before and after the LAF machine was turned on. There was no difference between day 1 and day 2, indicating no significant fluc- tuation in day-to-day measurements. Further- more, there was no significant difference in particle size and quantity of particles with the LAF turned on or off. Review of "Aerosol generation during phacoemulsification in live patient cataract surgery environment" Hans Andrews, MD Ophthalmology Resident Vanderbilt University Medical Center Nashville, Tennessee Jordan Comstock, MD Ophthalmology Resident Vanderbilt University Medical Center Nashville, Tennessee I n March 2020, COVID-19 placed an enor- mous stress on healthcare systems world- wide, and ophthalmologic cases were no exception. At the peak of the pandemic, many elective surgical services, including cataract surgery, were canceled. Ophthalmol- ogists were confronted with empty offices and operating rooms. Fortunately, as new protocols were implemented, elective cases began to resume. Physicians and administrators have been plagued with the responsibility to reopen operative suites while also keeping patients and staff safe. The idea that cataract surgery is an aerosol- generating procedure is up for debate. If aerosol is generated from the lens or aqueous material, this could result in the spread of COVID-19 in the operating room. The purpose of this study was to characterize and quantify the generation of aerosol in the operating theater during cata- ract surgery on human eyes. The authors divided the study into two parts: a preliminary study and a follow-on study. In both parts, the authors included patients aged 50–80 who had visually significant cata- racts and no other ophthalmic comorbidities. The ASCRS Journal Club is a virtual, compli- mentary CME offering exclusive to ASCRS members that brings the experience of a lively discussion of two current articles from the Journal of Cataract & Refractive Surgery to the viewer. Co-moderated by Nick Mamalis, MD, and Leela Raju, MD, the June session featured a presentation by David Belyea, MD, co-author of "The effect of eye drops and applanation tonometry on optical biometry." The second manuscript, "Aero- sol generation during phacoemulsification in live patient cataract surgery environ- ment" was presented by Hans Andrews, MD, ophthalmology resident, Vanderbilt Eye Institute. To view the June Journal Club session, visit ascrs.org/clinical-education/ journal-club/schedule/june-2021. Jennifer Lindsey, MD Director for Resident Education Department of Ophthalmology and Visual Sciences Vanderbilt University Medical Center Nashville, Tennessee

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