Division of Urology, Southern Illinois University, Springfield, Illinois 62794, USA.
J Urol. 2013 Jul;190(1):139-43. doi: 10.1016/j.juro.2013.01.081. Epub 2013 Jan 30.
The human eye is a highly radiosensitive portion of the body and repeat radiation exposure can lead to cataract. The minimum fractionated long-term dose to initiate cataract formation is about 2,500 mSv. We determined whether further radiation related precautions are necessary to protect the eyes of the surgeon.
Radiation doses received near the right eye of the operating surgeon were measured with a thermoluminescent dosimeter badge worn near the eye of 6 urologists for a single endourological procedure at an academic center. Procedures included stent insertion, ureteroscopic lithotripsy and percutaneous nephrolithotomy. The mean radiation dose was calculated. Extrapolated doses required to potentiate cataract formation were also calculated.
We assessed 28 urological procedures for radiation exposure, of which 13 were ureteroscopy done for calculus disease (range 0.05 to 0.66 mSv) and 7 were ureteral stent insertion (range 0.13 to 0.32 mSv). The mean radiation dose received during these cases was 0.208 mSv. Based on the mean dose and an average of 20 such cases per month, it would take about 50 years to reach the minimum threshold for progressive cataract formation. Eight percutaneous renal operations were performed and the mean dose received was 0.125 mSv (range 0.04 to 0.22). Based on 10 cases per month, this would require more than 160 years of exposure to reach the minimal threshold.
Long-term radiation can lead to cataract formation. However, the accumulated lifetime exposure of the typical urologist may not necessitate further safety precautions, such as lead-lined glasses.
人体眼睛是对辐射高度敏感的部位，重复辐射暴露可导致白内障。引发白内障形成的最低分次长期剂量约为 2500mSv。我们旨在确定是否需要进一步采取辐射防护措施来保护外科医生的眼睛。
在学术中心，我们使用佩戴于 6 位泌尿科医生眼部附近的热释光剂量计测量了进行单次内镜泌尿外科手术时手术医生右眼附近接收到的辐射剂量。手术包括支架置入、输尿管镜碎石术和经皮肾镜取石术。我们计算了平均辐射剂量，并推算出可能引发白内障形成的辐射剂量。
我们评估了 28 例泌尿外科手术的辐射暴露情况，其中 13 例为结石病行输尿管镜检查（范围 0.05 至 0.66mSv），7 例为输尿管支架置入（范围 0.13 至 0.32mSv）。这些情况下，医生接收到的平均辐射剂量为 0.208mSv。基于平均剂量和每月平均 20 例此类手术，要达到渐进性白内障形成的最低阈值需要大约 50 年。进行了 8 例经皮肾手术，平均接收到的辐射剂量为 0.125mSv（范围 0.04 至 0.22）。基于每月 10 例手术，这需要超过 160 年的暴露时间才能达到最低阈值。
长期辐射可导致白内障形成。然而，典型泌尿科医生的累积终生暴露可能不需要进一步的安全防护措施，如铅玻璃眼镜。
