AEROSOLIZATION OF INFECTIOUS VIRUS BY EXCIMER-LASER

PURPOSE: To determine the potential for aerosolization of infectious v irus present within the tear film during excimer laser photoablation o f the cornea. METHODS: Cell monolayers infected with her pes simplex v irus or adenovirus, simulating virus-infected corneas, were ablated wi th the 193-nm excimer laser. Adjacent dishes containing noninfected ce ll monolayers were subsequently assayed for viral infection. RESULTS: Viral spread to sentinel dishes occurred with both herpes simplex and adenovirus. The titer of virus present in the infected cell monolayers influenced the likelihood of spread to adjacent dishes. The presence of a vacuum aspiration system appeared to influence the direction of v irus spread, with dishes located in the direction of the vacuum most l ikely to contain virus. CONCLUSIONS: The potential for aerosolization of infectious virus exists with photoablation using a large-diameter e xcimer laser beam, Our experimental design, however, does not prove th at spread of infectious virus is likely to occur in the clinical setti ng. Appropriate measures should be taken to reduce the possibility of the spread of virus from the patient to the surgeon, other medical sta ff, or other patients.