Ophthalmology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
J Cataract Refract Surg. 2010 Aug;36(8):1344-8. doi: 10.1016/j.jcrs.2010.02.013.
To evaluate occupational ultraviolet (UV) exposure during photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with the Allegretto Wave Eye-Q 400 Hz excimer laser.
Walter Reed Center for Refractive Surgery, Washington, DC, USA.
Intraoperative UV measurements were performed during PRK with epithelial removal using an Amoils brush, PRK with epithelial removal using 20% ethanol, or femtosecond LASIK. A LaserStar power/energy meter with a silicone detector (model PD-10) was used for the measurements. The maximum pulse energy 25.4 cm from the corneal surface was recorded for each surgical procedure. Measurements were evaluated using a worst-case scenario for exposure of operating room personnel, and the results were compared with the occupational exposure limit set by the International Commission on Non-Ionizing Radiation Protection.
Measurements were taken during 15 cases of each procedure. The mean maximum exposure was 129.38 nJ/pulse +/- 79.48 (SD) during brush PRK, 69.72 +/- 68.80 nJ/pulse during ethanol PRK, and 29.17 +/- 13.82 nJ/pulse during LASIK. The mean maximum exposure per eye was 0.085 mJ/cm(2), 0.046 mJ/cm(2), and 0.01 mJ/cm(2), respectively. The worst-case cumulative exposure during a heavy workday of 20 patients (40 eyes) was calculated at 3.92 mJ/cm(2), 1.51 mJ/cm(2), and 0.79 mJ/cm(2) for brush PRK, ethanol PRK, and LASIK, respectively.
Results indicate that the excimer laser platform used in the study may yield greater UV exposure than previous systems; however, the levels did not exceed occupational exposure limits.
No author has a financial or proprietary interest in any material or method mentioned.
使用 Allegretto Wave Eye-Q 400 Hz 准分子激光评估光折射性角膜切削术（PRK）和激光原位角膜磨镶术（LASIK）中的职业紫外线（UV）暴露。
美国华盛顿特区 Walter Reed 屈光手术中心。
在使用 Amoils 刷进行 PRK 上皮去除、使用 20%乙醇进行 PRK 上皮去除或飞秒 LASIK 时，进行术中 UV 测量。使用带有硅树脂探测器（型号 PD-10）的 LaserStar 功率/能量计进行测量。记录距角膜表面 25.4cm 处的最大脉冲能量。使用手术室人员暴露的最坏情况评估测量值，并将结果与国际非电离辐射防护委员会设定的职业暴露限值进行比较。
对每种手术程序各进行 15 例测量。在刷 PRK 中，最大暴露均值为 129.38nJ/脉冲±79.48（SD）；在乙醇 PRK 中为 69.72±68.80nJ/脉冲；在 LASIK 中为 29.17±13.82nJ/脉冲。每只眼的最大平均暴露量分别为 0.085mJ/cm2、0.046mJ/cm2 和 0.01mJ/cm2。计算出 20 名患者（40 只眼）重度工作日的最坏情况累积暴露量分别为 3.92mJ/cm2、1.51mJ/cm2 和 0.79mJ/cm2，用于刷 PRK、乙醇 PRK 和 LASIK。
结果表明，与以前的系统相比，研究中使用的准分子激光平台可能会产生更大的 UV 暴露，但并未超过职业暴露限值。
