Outpatient cataract surgery with laminar air flow safe, efficient during pandemic
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At a district general hospital in the United Kingdom, an efficient and safe outpatient cataract surgery service was developed to prevent transmission of COVID-19, leading to high patient satisfaction.
“Surgery was performed in clean rooms using the Toul Operio Mobile device to create a sterile site,” Radhika Patel, MD, said at the virtual European Society of Cataract and Refractive Surgeons winter meeting.
At the start of the COVID-19 pandemic, nonurgent surgery was halted to reduce transmission of the virus. Approximately 28 million routine surgeries were canceled worldwide, 43,000 per week in the U.K.
“To reintroduce surgery, we developed a safe streamline pathway with a one-way system. Patients come into the department from the main entrance, where temperature is taken. They are brought around to the outpatient department, booked in for surgery, given a dilating agent and then asked to wait in their cars with a buzzer. When it’s time, they come back to the department, see the surgeon and are taken straight to a clean room where surgery is performed. After postoperative care is explained to them, they are discharged to go home,” Patel said.
The Operio Mobile air zone unit used for surgery creates a direct flow of filtered ultraclean air that is directed over the surgical site and sterile instruments. In addition, staff movements in the room are minimized, and from the start of surgery, doors are not opened.
Using this new pathway, 515 patients underwent phaco with IOL insertion in two clean rooms by five senior surgeons. The initial 100 patients were studied in detail. The average time spent within the department was well below the 90 minutes recommended by the Royal College of Ophthalmologists guidelines. Average time was 74.3 minutes for unilateral cases, ranging between 40 and 100 minutes, and 93.1 minutes for bilateral cases, ranging between 60 and 120 minutes.
At 2 weeks, patients were contacted on the telephone. No patients reported complications or COVID-19 symptoms.
“Patients reported a high level of satisfaction with the system, with an average of 9.5 out of 10 mentioning they felt it was smooth, efficient, and made them feel safe and less vulnerable,” Patel said.
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Patel R, et al. Cataract surgery in an outpatient clean room using a portable laminar air flow device – efficient, effective and safe. Presented at: European Society of Cataract and Refractive Surgeons winter meeting; Feb. 19-21, 2021 (virtual meeting).
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