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Kelly Ma, Bonnie Henderson; Ophthalmic air filtration practices in hospital and community settings and its role in modern day surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):811.
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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.
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.
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.
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.
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