Lee Min Joon, Czajkowski Simon, Gershon Ariel, Sabljic Thomas, Acosta Gad, Kazlovich Kate, Lee Jason Y
Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Division of Urology, Department of Surgery, University Health Network, Toronto, ON, Canada.
Can Urol Assoc J. 2022 Aug;16(8):283-288. doi: 10.5489/cuaj.7770.
We conducted a study using an ex-vivo porcine model to evaluate whether a thulium fiber laser (TFL) induces ocular injury in the context of inadvertent exposure to the laser beam.
A 365 μm TFL was positioned at a set distance (0 cm, 5 cm, 8 cm, and 10 cm) from a freshly harvested (<12 hours) porcine eyeball and the laser was activated for one second at select laser settings for lithotripsy (0.2 J at 50 Hz, 0.5 J at 20 Hz, and 1 J at 10 Hz) and soft tissue ablation (2 J at 10 Hz, 1 J at 50 Hz). The experiment was repeated with laser safety goggles and prescription eyeglasses. Thermal injury was assessed by histopathological analysis.
Without eye protection, corneal injury was observed even at 10 cm away for one lithotripsy setting (1 J at 10 Hz) and both tissue ablation settings. All thermal injuries observed were superficial only, except for at 0 cm distance, where deep-layer injury was observed. Laser safety goggles offered complete protection regardless of setting or distance. Partial protection was demonstrated with prescription glasses: histopathological damage was observed for both soft tissue ablation settings and only at 0 cm for two lithotripsy settings (0.5 J at 20 Hz, 1 J at 10 Hz).
The TFL can induce ocular injury at close distances and at higher power settings. The use of laser safety goggles confers complete protection while prescription eyeglasses confer partial protection. Further study is warranted.
我们使用离体猪模型进行了一项研究，以评估在意外暴露于激光束的情况下，铥光纤激光器（TFL）是否会导致眼部损伤。
将一台365μm的TFL放置在距刚摘取的（<12小时）猪眼球一定距离处（0厘米、5厘米、8厘米和10厘米），并在用于碎石术（50Hz时0.2J、20Hz时0.5J、10Hz时1J）和软组织消融（10Hz时2J、50Hz时1J）的选定激光设置下激活激光一秒钟。佩戴激光安全护目镜和处方眼镜重复该实验。通过组织病理学分析评估热损伤。
在没有眼部防护的情况下，即使在10厘米远处，对于一种碎石术设置（10Hz时1J）以及两种组织消融设置，均观察到角膜损伤。观察到的所有热损伤均仅为浅表性损伤，但在0厘米距离处观察到深层损伤。无论设置或距离如何，激光安全护目镜均提供了完全保护。处方眼镜显示出部分保护作用：对于两种软组织消融设置以及仅在0厘米处的两种碎石术设置（20Hz时0.5J、10Hz时1J）观察到了组织病理学损伤。
TFL在近距离和较高功率设置下可导致眼部损伤。使用激光安全护目镜可提供完全保护，而处方眼镜提供部分保护。有必要进行进一步研究。
