VERY basic questions regarding laser safety intraop

[jsh1986]

Advertisement - Members don't see this ad

I have been scrubbing in on a lot of retina cases lately and we often use endo or BIO lasers.

I'm not sure I fully understand the risks of using lasers in the OR (my safety introduction was very bad).

- I realize the microscope is equipped with a filter which will protect my vision from reflections of the laser, but I sometimes will rest by sitting about 1-2 cm away from the eyepieces. Is there any risk that a laser light from an endolaser source could hit my "unprotected" eye if I didn't have it directly up to the eye piece?

- The scrub nurse doesnt wear safety goggles when we are using the endolaser and sometimes she will be standing beside us and looking at the eye while the laser in use. Is she at risk for potentially being blinded if she is looking at the eye when the laser is in use?

- Also, when the BIO is being used everyone in the room wears safety goggles, but today for example, someone walked into the OR mistakenly while the laser was being shined into the patient's eye to perform a coaug. Does looking at the laser stream put you at risk, or do you have to have the terminal end enter your eye?

Again, very busy but some things I wasnt clear on...

 

[odieoh]

As long as the surgeons don't cross the laser streams everything will be ok.

 

[jsh1986]

As long as the surgeons don't cross the laser streams everything will be ok.

Sorry can you just clarify what you mean by crossing the laser streams?

 

[JMK2005]

The person getting the brunt of the laser beam is the patient, and they are certainly not "blinded" by the laser. The reflected laser is much more attenuated than the direct beam. It's a safety precaution. It probably wouldn't matter much on a occasional basis if you don't have protection on, but I wouldn't be do it all the time.

 

[JMK2005]

Sorry can you just clarify what you mean by crossing the laser streams?

http://www.luckyjacks.com/images/pages/lazermaze3tween.jpg

 

[jsh1986]

I know of course just enough to worry myself, ie
http://www.nejm.org/doi/full/10.1056/NEJMc1005818

Thanks for the clarifications!!

 

[odieoh]

http://www.luckyjacks.com/images/pages/lazermaze3tween.jpg

Well, I was thinking more along the lines of:

http://i.imgur.com/kLvQ3.jpg

but yours will do as well 😉

 

[Visionary]

My understanding is that it is an OSHA requirement that all present during a laser procedure wear eye protection. That said, the likelihood of injury from scattered laser light is negligible. The bigger concern would be if the laser were to be unintentionally fired at the wrong target (e.g., an observer's eye). That is actually more of a risk with a BIO-mounted laser. I did see, in residency, an ENT resident who accidentally looked into an armed laser following a procedure. It missed his fovea by less than 100 microns and he now has an annoying blind spot.