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MA Hammons, JA Woodward; Reflected CO2 Laser Energy and Damage to Operative Field Materials . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1108.
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Purpose: This study investigates the risks of damage to operative field materials from reflected CO2 laser energy and compares the damage created by the laser when reflected off of a sandblasted versus a polished instrument. Methods: The CO2 laser, using incisional settings, was reflected off of the sandblasted surface of a Jaeger lid plate and subsequently off of the polished portion of the same plate. Target materials included a surgical glove, an operative gown, laser safety-goggles, and an endotracheal tube. These materials were fixed along the laser's angle of reflection at varying distances from the reflective surface. For each reflective surface, three separate trials were performed with each target at each distance . Observational data collected included time to initial grossly visible change in the target material, a description of the effect on the target material, and the size of this effect. Analysis of variance was used to assess the significance of variation between the time to initial change when the laser was reflected off of the sandblasted versus the polished surface. Results: 1. Reflected CO2 laser energy created a hole in the glove in each trial. 2. The laser created either a hole with smoke and flame or a charred area on the surgical gown for all trials. 3. When aimed at the safety-goggles, the laser created a surface divot at 5 and 10 cm and only heat at 15 cm. 4. At 5 and 10 cm, the laser created a divot in the surface of the endotracheal tube, while at 15 cm tube surface irregularities were palpable but not visible. 5. For each target material and distance except one, the average time to initial change was shorter when the laser was reflected off of the polished surface versus the sandblasted surface. This was statistically significant for the surgical glove at 10 centimeters (p=0.004) and 15 centimeters (p=0.003), for the surgical gown at 10 centimeters (p=0.026) and 15 centimeters (p<0.001), and for the tube at 10 centimeters (p<0.001). The variation was not found to be significant for any of the targets when placed at 5 centimeters from the reflective surfaces. For the goggles and the endotracheal tube, no visible change on laser firing was noted when the targets were fixed at 15 centimeters, so no analysis was performed. Conclusion: Reflected CO2 laser energy can cause damage to operative field materials at least 15 cm away from both sandblasted and polished surfaces. The time to damage is usually shorter off of a polished instrument versus a sandblasted one. However, when the target material is within 5 centimeters of the reflective surface, there is no statistical difference between the time to damage of that target for a sandblasted as opposed to a polished reflective surface.
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