Abstract
Purpose:
Air injection is commonly used in ophthalmic surgeries. It is unclear from a review of the literature whether there is a medical basis for air filtration. This practice, however, still continues today. Over the past few decades, operating room air quality standards have improved and employ a conventional plenum ventilation system through which particles greater than five microns are removed to obtain a dramatic reduction of colony forming units (50-150 CFUs/m3) as well as surgical morbidity.1,2 This study explores the purpose of direct air filtration for intraocular surgery and examines the incidence of use in various clinical settings.
Methods:
Ophthalmic surgeons were surveyed across the US and internationally, in both university/hospital and private practice/ambulatory surgical center settings, regarding the use of air filters during ophthalmic surgery, including but not limited to cataract, cornea, and retina surgeries.
Results:
33 surgeons in university/hospital centers and 40 surgeons in ambulatory surgery centers responded to the survey. In the university/hospital setting, 39.4% of respondents filter air prior to intraocular delivery internationally and 44.4% nationally. In ambulatory surgery centers, 32.5% of respondents filter air prior to intraocular delivery internationally and 35.1% nationally. Neither international (z=0.613; p=0.540) nor US (z=0.753; p=0.451) filtration practice proportions were statistically significant between the two types of surgery centers using a 95% CI.
Conclusions:
Previous studies did not demonstrate or support the need to filter air for microbes.3 However, approximately one-third of operating rooms and ambulatory care centers still filter air. This practice adds several minutes and approximately $2.00 in medical supply cost to each surgery and may be unnecessary. References: 1. Dharan S and Pittet D. Environmental controls in operating theatres. J Hosp Infect. 2002 Jun;51(2):79-84. 2. Landrin A et al. Monitoring air sampling in operating theatres: can particle counting replace microbiological sampling? J Hosp Infect. 2005 Sep;61(1):27-9. 3. Schneider TL et al. The microbiologic effect of gas filtration. Retina. 1996;16(2):125-8.
Keywords: 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower •
462 clinical (human) or epidemiologic studies: outcomes/complications •
465 clinical (human) or epidemiologic studies: systems/equipment/techniques