玻璃体切除术中的眼内照明及光毒性阈值。
Endoillumination during vitrectomy and phototoxicity thresholds.
作者信息
van den Biesen P R, Berenschot T, Verdaasdonk R M, van Weelden H, van Norren D
机构信息
FC Donders Institute of Ophthalmology, University Hospital Utrecht, Utrecht, Netherlands.
出版信息
Br J Ophthalmol. 2000 Dec;84(12):1372-5. doi: 10.1136/bjo.84.12.1372.
AIM
To assess the retinal phototoxicity hazards of and to provide safety margins for endoillumination during vitrectomy.
METHODS
The absolute power and spectral distribution from various light sources and filter combinations that are commercially available for vitreous surgery were measured. The maximal exposure times based on the ICNIRP safety guidelines for photochemical and thermal injury of the aphakic eye were calculated. Additionally, the effect of various measures that reduce the risk of phototoxicity was evaluated.
RESULTS
Measurements of the spectrum and energy indicated that the ICNIRP safety guidelines for photochemical retinal damage are exceeded within 1 minute for nine out of 10 combinations tested. With an additional 475 nm long pass filter, light levels below 10 mW, and a distance from light probe to retina of at least 10 mm, the allowable exposure time can be increased up to 13 minutes. Thermal damage can be anticipated when the light probe touches the retina.
CONCLUSION
Commercially available light sources for endoillumination during vitrectomy are not safe with respect to photochemical retinal damage. Even with maximal precautions macular phototoxic damage remains a factual danger during vitrectomy.
目的
评估玻璃体切除术中眼内照明的视网膜光毒性危害，并提供安全边际。
方法
测量了各种可用于玻璃体手术的市售光源和滤光片组合的绝对功率和光谱分布。根据国际非电离辐射防护委员会（ICNIRP）关于无晶状体眼光化学和热损伤的安全指南，计算了最大暴露时间。此外，还评估了各种降低光毒性风险措施的效果。
结果
光谱和能量测量表明，在所测试的10种组合中，有9种在1分钟内就超过了ICNIRP关于视网膜光化学损伤的安全指南。使用额外的475nm长波滤光片、低于10mW的光强以及光探头与视网膜至少10mm的距离时，允许的暴露时间可增加至13分钟。当光探头接触视网膜时，可预期会发生热损伤。
结论
就视网膜光化学损伤而言，市售的玻璃体切除术中眼内照明光源不安全。即使采取最大程度的预防措施，黄斑光毒性损伤在玻璃体切除术期间仍然是一个实际存在的危险。
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