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February 1993

Unsuspected Glove Perforation During Ophthalmic Surgery

Arch Ophthalmol. 1993;111(2):186-193. doi:10.1001/archopht.1993.01090020040019

• Objectives.  —To determine the rate of perforation of surgical gloves after ophthalmic surgery and to identify factors that contribute to the development of perforations.

Design.  —Case-control study of used and unused surgical gloves collected during a 7-month period.

Setting.  —The ophthalmology surgical suites of a major teaching hospital.Main Outcome Measures.—Development of glove perforations as measured by five different techniques.

Results.  —We tested 103 pairs of latex surgical gloves before use and 454 pairs of gloves after use. Of five techniques used to test for pinholes, air inflation with water submersion and compression was found to be the most sensitive, yielding a 6.80% prevalence in control glove pairs and a 21.81% prevalence in study glove pairs (P=.0005). When examined by subspecialty area, the lowest perforation rate (11.39%; P=.00009) occurred in cataract and intraocular lens surgery and the highest rate (41.67%; P=.003) occurred in oculoplastic surgery. Factors that correlated significantly with the development of perforations as determined by multiple logistic regression analysis included pediatric ophthalmology and strabismus surgeries, oculoplastic surgeries, level of training of the surgeon, duration of operation, and larger glove size. The thumb and index fingers of the nondominant hand contained the largest numbers of pinholes.

Conclusions.  —The rate of surgical glove perforation after ophthalmic surgery is relatively high. Recommendations for reducing the rate of glove perforation are discussed.