Perception and practice patterns of holmium laser goggles in endourological procedures: an unnecessary evil?

Author(s) Paterson, N.; Fitzpatrick, R.; Blew, B.; Denstedt, J.D.; Watterson, J.
Journal J Endourol
Date Published 2018 Oct 27

PURPOSE: The holmium laser is used increasingly for a wide array of urological procedures. Laser safety goggles are mandatory at many centers for individuals within the nominal hazard zone, as set out by the institution. Recent ex-vivo studies suggest standard eye wear may be equally as protective. We sought to evaluate the perceptions and practice patterns of laser safety goggles in urology.

MATERIAL AND METHODS: A 24 question survey was sent out via e-mail to an international email list of approximately 2000 urologists that were members of the Endourological Society. Data was collected anonymously using Survey Monkey.

RESULTS: Two hundred and sixty-four (14%) urologists completed the survey. Thirty-four percent worked in the community while 63% worked at an academic institution. Ninety-seven percent routinely used the holmium laser. The most common uses were lithotripsy (99%), tissue incision (71%), tumor ablation (58%) and prostate ablation (26%). Formal laser training and institutional laser safety policies were reported in 76% and 64%, respectively. Forty percent of respondents routinely wore laser safety goggles. Laser adverse events were witnessed by 19% but there were no eye injuries reported. Seventy percent of surgeons felt that laser safety goggles may impair their vision. When presented with the information that regular eye glasses may be as effective as laser goggles for preventing harm, the majority (86%) would opt for regular eye wear.

CONCLUSIONS: Laser safety eyewear practice patterns vary greatly. Many centers have adopted policies for universal mandatory laser goggles in the operating room. With over two thirds of surgeons suggesting laser goggles impair their vision, and recent literature suggesting regular eye wear is equivalent in preventing laser associated eye injuries, laser goggle safety policies should be updated to better match the potential hazards inherent to the device.

DOI 10.1089/end.2018.0432
ISSN 1557-900X
Citation J Endourol. 2018.

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