Lack of virus transmission by the excimer laser plume

PURPOSE: To test the possibility of pathogenic virus transmission into the operating suite during excimer laser treatment of corneal tissue. Such treatment vaporizes corneal tissue, which may put the surgeon at risk of infection from human immunodeficiency virus, hepatitis virus, or other viruses. We developed a model system to test the possibility of such virus transmission, METHODS: Pseudorabies virus is a porcine enveloped herpesvirus similar in structure and life cycle to human immunodeficiency virus and herpes simplex virus. An excimer laser was used to ablate a virus-infected tissue culture plate while an uninfected tissue culture plate was in an inverted position over the infected plate. Six hundred laser pulses were applied. Pseudorabies virus in the excimer laser plume would, potentially, contact and infect the uninfected cells. The experiment was repeated 20 times with appropriate positive and negative controls. RESULTS: None of the 20 uninfected plates was infected by the laser plume rising from ablation of infected tissue culture plates. Positive and negative controls performed as expected. CONCLUSIONS: Even under conditions designed to maximize the likelihood of virus transmission, the excimer laser ablation plume does not appear capable of transmitting this particular live enveloped virus. Excimer laser ablation of the cornea of a human immunodeficiency virus (HIV)-infected or herpesvirus-infected patient is unlikely to pose a health hazard to the surgeon.