Abstract
Purpose :
Since the start of the Covid-19 pandemic, it has become customary for ophthalmologist to wear surgical masks during slit-lamp exams, which causes more frequent fogging of the slit-lamp oculars. This can distort the ophthalmologist’s view, cause missed exam findings, and slow productivity. The study examines 4 interventions commonly used to combat ocular lens fogging to see which shows the most statistically significant effectiveness at preventing/reducing fogging of the slit-lamp.
Methods :
The interventions included 3 defogging solutions (Dawn soap, DeFogger solution, and Zeiss Fog defender) and 1 method of limiting escaped respirations (mask taping). One application of defogging solution was applied to a slit-lamp’s oculars. This was repeated on additional, identical slit-lamps for each defogging solution plus a distilled water control. A simulator mimicking an ophthalmologist’s respirations while wearing an ASTM level 3 surgical mask was positioned at the slit-lamp. The level of fogging after each artificial respiration was given a score of 0-4. This was repeated 30 times per solution. For the mask taping intervention, the top edge of the ASTM level 3 surgical mask was secured to the respiration simulator with tape. The method of recording level of fogging was the same as the other interventions.
Results :
Data was analyzed using statistical software from Prism and Excel. The ANOVA, confidence interval, mean difference, and P-value were calculated for each intervention and compared to the control. Statistically significant P-values were defined as <0.05. Control compared to Zeiss solution: mean difference (Md) 1.33, confidence interval (CI) 0.4552 to 2.211, and P-value 0.0005. Control compared to defogging solution: md 1.067, CI 0.1886 to 1.945, and P-value 0.0088. Control compared to Dawn soap: Md 1.6, CI 0.7219 to 2.478, and P-value <0.0001. Control compared to mask taping: Md 0.9667, CI 0.08858 to 1.845, and P-value 0.0231. The interventions were also compared to each other using the md, CI, and P-value.
Conclusions :
The results showed each intervention provided a statistically significant improvement in the level of fogging compared to the control. No statistical significance was found when comparing interventions to each other. This study emphasizes there are multiple achievable interventions physicians can consider to maintain the quality of slit-lamp exams with the additional fogging that surgical masks generate.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.