Evaluation of the presence of SARS-CoV-2 in the aqueous humor and vitreous in patients undergoing combined phaco-vitrectomy surgery

Abstract

Purpose: To investigate the presence of virus in the aqueous humor and vitreous of patients undergoing elective combined cataract and pars plana vitrectomy during the Coronavirus disease 2019 (COVID-19) pandemic. Materials and methods: In this prospective cross-sectional study, of the patients to undergo elective surgery, those who had a negative severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2) nasal swab test 24-72 hours prior to the surgery and who were asymptomatic were included. SARS-CoV-2 IgG antibodies were evaluated in blood samples taken 24-72 hours before the operation. 0.1 cc of aqueous humor and 0.1 cc of vitreous fluid were aspirated at the beginning of the surgery. The presence of SARS-CoV-2 viral ribonucleic acid (RNA) was evaluated by real-time reverse transcriptase polymerase chain reaction (RT-PCR). Results: Of 66 participants, 39 were male (59.1%) while 27 were female (40.9%). Twenty five patients (37.8%) had a history of COVID-19 between 20 days - 60 days (mean 49 days) before the surgery. There were 58 patients (87.9%) with a history of vaccination before the operation and 8 patients (12.1%) without a history of vaccination. No SARS CoV 2 RNA was detected in the aqueous humor and vitreous samples of any patient. IgG against SARSCoV-2 was detected in 3 patients who had not been vaccinated against COVID-19 before and had no known history of COVID-19. Conclusion: We did not find any SARS-CoV-2 viral genetic material in the aqueous and vitreous fluids of asymptomatic participants whose nasal swab test was negative, even if they recently had COVID-19.