Study of Cataract & Vitrectomy Surgery as Aerosol Generating Procedure [COVID-19]
Research type
Research Study
Full title
An Observational Study of Imaging during Phacoemulsification and Vitrectomy Surgery as Aerosol Generating Procedures and Coronavirus Disease 19 Risks in Ophthalmology (VADAR study)
IRAS ID
283910
Contact name
Mahiul MK Muqit
Contact email
Sponsor organisation
Moorfields Eye Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
COVID-19 pandemic has caused major changes to working practices of NHS hospital healthcare professionals. Cataract is the commonest cause of avoidable blindness, ~400,000 cataract surgeries are done by high-speed 40kHz phacoemulsification in the UK.Vitrectomy surgery is done to prevent severe visual impairment and uses high-speed cutters inside the eye. Both phacoemulsification and vitrectomy are classified as “aerosol generating procedures” (AGPs) by the Royal College of Ophthalmologists according to Public Health England guidance.There are risks of droplets being blown into the room air during AGP operations. Consequently, personal protective equipment (PPE) and infection/prevention/control measures have been increased to maintain safety of patients and hospital staff. National AGP guidance will slow down NHS efficiency, and significantly increase PPE use as mitigating measures in the COVID-19 pandemic and beyond. Critically, we will be restricted in our capacity to treat patients, increasing risks of visual impairment in the UK.\n\nHowever, there has never been a study conducted in hospitals to prove this AGP theory for either surgery procedure. We have partnered the NHS with the University Mullard Space Science Laboratory to answer a COVID-19 medical need and prevent ongoing morbidity and sight loss. Our study aligns with the World Health Organisation knowledge gap of COVID-19 priority research theme “Infection/Prevention/Control and healthcare workers PPE.”\n\nOur study uses specialised LED-illumination/shadowgraphy imaging linked to exisiting operating microscope and a class 1 laser imaging system to characterize (size/shape, virus-size particles) and detect aerosol particles generated in the surgical airfield during cataract and vitrectomy operations in real-time at micron-scale.We will test ocular samples for COVID-19 to externally validate aerosol virus detection. If we confirm surgery is an AGP, the NHS protective steps can be validated. If we confirm that surgery is not an AGP, then this has major positive impact on healthcare resources, costs, efficiency and PPE supply chains.
REC name
London - Fulham Research Ethics Committee
REC reference
20/HRA/2271
Date of REC Opinion
2 Jun 2020
REC opinion
Further Information Favourable Opinion