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donald gauldin, Scott Ferguson, Sallam Ahmed, Sami Uwaydat; EXPOSURE OF CONTRALATERAL EYES TO LASER RADIATION DURING RETINAL PHOTOCOAGULATION. Invest. Ophthalmol. Vis. Sci. 2017;58(8):89.
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© ARVO (1962-2015); The Authors (2016-present)
The ocular hazardous effects of medical lasers are well documented, resulting in eighty-two pages of safety regulations issued by the American National Standards Institute (ANSI), that regulate medical laser use. However, no provisions are made for protection of the non-treated eye. We designed an experimental model to investigate the risk of laser damage to the unprotected untreated eye of patients undergoing panretinal photocoagulation (PRP) with PASCAL laser.
A mannequin was fitted with a portable laser power meter (Vega PD300-UV photodiode laser sensor). Simulated PRP treatments were performed on a model eye fitted in one of the sockets of the mannequin, while the laser sensor was placed in apposition to the opposite socket. Four simulated sessions of PRP were performed using the Mainster 165 lens held in front of the model eye. Each consisted of 10 laser applications directly into the model eye and 10 applications near but not directly into the sensor,utilizing standard PRP treatment settings.
First session (slit lamp laser, power 300 mw, size 200 µm, exposure 30 ms, single burst): there was no recorded exposure in the sensor when the laser was applied directly into the model eye or when applied near the sensor. Second session (slit lamp laser, power 700mw, size 200 µm, exposure 100 ms, single burst): no recorded exposure when applied directly into the model eye. When applied near the sensor, the mean recorded exposure was 0.003315 +/- 0.002176 µj (range 0.001-0.00737 µj, SD 95% CI 0.001513 to 0.004016 µj). Third session (indirect laser, power 700mw, 20D lens, exposure 100 ms, single burst): no recorded exposure when applied directly into the model eye. When applied near the sensor, mean recorded exposure was 0.0056+/- 0.005123 µj (range 0.0019-0.0144 µj, SD 95% CI 0.003523 to 0.009352). Fourth session (slit lamp laser, power 1000 mw, size 200, exposure 100 ms, single burst): no recorded exposure when applied directly into the model eye. When applied near the sensor, mean exposure was 0.005254 +/- 0.001324 µj (range 0.00409-0.07 µj, SD 95% CI 0.000910 to 0.00241).
Our data demonstrates that average laser radiation exposure of the untreated eye during PRP laser is well under the maximum permissible exposure limits allowed for retinal tissue, supporting current practices of not providing protection for the untreated eye of patients undergoing PRP with the PASCAL laser machine.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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