Are X-ray Safety Glasses Alone Enough for Adequate Ocular Protection in Complex Radiological Interventions?

The maximum annual radiation ocular dose limit for medical staff has been reduced to 20 mSv in the current European directive 2013/59/Euratom. This multi-centric study aims at reporting the protected and unprotected eye lens doses in different fluoroscopically guided interventions and to evaluate any other factors that could influence the ocular dose. From July 2018 to July 2019, ocular radiation doses of six interventionists of four departments during complex interventions were recorded with a thermoluminescent dosimeter in front of and behind radiation protection glasses to measure the protected and unprotected doses. The position of personnel, intervention type, fluoroscopy time, total body dose and use of pre-installed protection devices like lead acrylic shields were also systematically recorded. Linear regression analysis was used to estimate the doses at 2 y and 5 y. The annual unprotected/protected ocular doses of six interventionists were 67/21, 32.7/3.3, 27.4/5.1, 7/0, 21.8/2.2, and 0/0 mSv, respectively. The unprotected dose crossed the 20-mSv annual limits for four interventionists and protected dose for one less experienced interventionist. The estimated 5-y protected ocular dose of this interventionist was 101.318 mSv (95%CI 96.066-106.57), also crossing the 5-y limit. The use of a lead acrylic shield was observed to have a significant effect in reducing ocular doses. The annual unprotected and protected ocular doses for interventionists dealing with complex interventions could cross the present permitted yearly limit. The measurement of significant protected ocular dose behind the radiation protection glasses emphasizes the additional indispensable role of pre-installed radiation protection devices and training in reducing radiation doses for complex procedures.