Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.
GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.
World J Urol. 2019 Dec;37(12):2639-2647. doi: 10.1007/s00345-019-02667-0. Epub 2019 Feb 8.
During endourological procedures, the eye of the urologist is exposed to hazards such as contact with body fluids and irrigation solutions as well as laser injury, and X-ray radiation absorption. The resulting potential injuries and damages to the eye have not been summarily reviewed to date. The objective was to review the different risks of exposure to the eyes of urologists during endourological procedures.
The Medline database was searched for identification of studies on hazards to the eye of the endourologist. All articles published in English until September 2018 were considered.
Twenty-three publications were included in this analysis. The incidence of eye contact with patient body fluids or irrigation solutions during endoscopic procedures ranged between 37.50 and 100%. Laser-induced eye injuries were reported in 37.9% of all kind of adverse events related to laser use in urology. The eye lens dose of radiation ranged from 0.04 to 1600 µSv per endourological procedures.
While the risks of infection, laser injury, lens opacity and cataract are generally low, the wear of protective glasses is recommended. Lead glasses may protect against all these risks in case of Ho:YAG laser use with concomitant X-ray radiation. If Ho:YAG laser is used without any concomitant X-ray radiation, proper laser safety glasses or at least conventional eyeglasses should be recommended. When other types of laser are used, we recommend wearing laser eye protection glasses covering the adequate range of wavelength. For endourological procedures without laser use and X-ray radiation, specific protection devices such as goggles or face shields are recommended.
在腔内泌尿外科手术过程中，泌尿科医生的眼睛会接触到诸如体液和灌洗液接触、激光损伤和 X 射线辐射吸收等危害。迄今为止，尚未对由此产生的眼部潜在损伤和损害进行全面评估。本研究旨在回顾腔内泌尿外科手术过程中泌尿科医生眼睛暴露于不同风险的情况。
在 Medline 数据库中搜索有关腔内泌尿外科医生眼部危害的研究。纳入所有截至 2018 年 9 月发表的英文文章。
本分析共纳入 23 篇文献。在内镜手术过程中，眼部接触患者体液或灌洗液的发生率在 37.50%至 100%之间。在所有与泌尿科激光使用相关的不良事件中，有 37.9%报告了激光致眼损伤。辐射晶状体剂量范围为每次腔内泌尿外科手术 0.04 至 1600µSv。
虽然感染、激光损伤、晶状体混浊和白内障的风险通常较低，但建议佩戴防护眼镜。如果在使用 Ho:YAG 激光的同时伴有 X 射线辐射，铅玻璃可能会预防所有这些风险。如果在没有任何 X 射线辐射的情况下使用 Ho:YAG 激光，则应建议使用适当的激光安全眼镜或至少常规眼镜。如果使用其他类型的激光，则建议佩戴涵盖适当波长范围的激光眼部防护眼镜。对于没有激光使用和 X 射线辐射的腔内泌尿外科手术，建议使用护目镜或面罩等特殊防护设备。
