This document is advisory and individual clinicians must assess each case in light of local policy and equipment availability. Only urgent oculoplastic procedures which cannot be delayed should be performed during the current crisis.
- PPE Recommendations for Oculoplastics Surgery
In line with PHE’s advice the following PPE is appropriate in any oculoplastic procedure;
Fluid repellent surgical gown
Disposable gloves
Eye protection and face shield
Fluid resistant face mask i.e. a surgical mask (Type IIr)
- PPE for High Risk, Aerosol Generating Procedures (AGP)
For procedures which generate aerosols, in particular lacrimal procedures, other procedures involving the nasal or sinus cavities, open suctioning, and orbital surgery using power tools, and when working in theatres where AGPs are being performed by others, PHE guidance should be followed and the higher level of PPE detailed below should be used. For prolonged procedures under local anaesthetic in close proximity to the patient, there should be an individual risk assessment to consider whether higher level of PPE is warranted.
Fluid repellent surgical gown
Double surgical disposable sterile gloves
Eye protection and face shield
Filtering face piece with respirator FFP3 face mask type.
All disposable PPE should be removed and disposed as healthcare waste. Meticulous hand hygiene is to be performed immediately on removal of PPE. All patients should be encouraged to wear a fluid resistant face mask, if practical, during and after procedures as well as clinic consultation.
- General Measures to reduce risks during surgery
Due to the potential for aerosols to be generated by breathing, speech, coughing or sneezing;
Optimising theatre airflow and liaise with the anaesthetist to reduce the exposure of all members of the surgical team to the patient’s exhaled air.
Draping and masking the patient where possible, with minimal dialogue during the procedure.
Adhesive drapes which form a barrier to exhaled air between the patient and the surgeon
Minimising the length of the procedure.
Increasing the operating distance by using a microscope or loupes if practical.
Pooling cases which require FFP3 protection to a single list to make best use of limited equipment.
Advice will change as new evidence comes to light and BOPSS and RCOphth will continue to update members.
Useful supporting links and documents:
Coronavirus (COVID-19): what you need to do
https://www.gov.uk/coronavirus
HSE: Information about health and safety at work
https://www.hse.gov.uk/