Laser safety eyewear.
In spite of repeated warnings about laser safety practices, as well as the availability of laser safety eyewear (LSE), eye injuries continue to occur during use of surgical lasers, as discussed in the Clinical Perspective, "Laser Energy and Its Dangers to Eyes," preceding this Evaluation. We evaluated 48 models of LSE, including goggles, spectacles, and wraps, from 11 manufacturers. The evaluated models are designed with absorptive lenses that provide protection from CO2 (carbon dioxide), Nd:YAG (neodymium:yttrium-aluminum-garnet), and 532 (frequency-doubled Nd:YAG) surgical laser wavelengths; several models provide multiwavelength protection. (Refer to ECRI's Product Comparison System report on LSE for specifications of other models.) Although most of the evaluated models can adequately protect users from laser energy--provided that the eyewear is used--many models of LSE, especially goggles, are designed with little regard for the needs of actual use (e.g., adequate labeling, no alteration of color perception, sufficient field of vision [FOV], comfort). Because these factors can discourage people from using LSE, we encourage manufacturers to develop new and improved models that will be worn. We based our ratings primarily on the laser protection provided by the optical density (OD) of the lenses; we acknowledge the contribution of Montana Laser Optics Inc., of Bozeman, Montana, in performing our OD testing. We also considered actual-use factors, such as those mentioned above, to be significant. Among the models rated Acceptable is one whose labeled OD is lower than the level we determined to be adequate for use during most laser surgery; however, this model offers protection under specific conditions of use (e.g., for use by spectators some distance from the surgical site, for use during endoscopic procedures) that should be determined by the laser safety officer (LSO). LSE that would put the wearer at risk are rated Unacceptable (e.g., some models are not properly or clearly labeled, have measured ODs that are not adequate for protection, or significantly restrict the wearer's FOV); also, LSE with side shields that do not offer adequate protection from diffuse laser energy are rated Unacceptable. Those models that offer adequate protection for surgical applications, but whose measured OD is less than their labeled OD, are rated Acceptable--Not Recommended; if the discrepancy is great, they are rated Unacceptable. Those models whose labels were removed during cleaning are rated Conditionally Acceptable.(ABSTRACT TRUNCATED AT 400 WORDS)
D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005131:Eye Injuries / Q000209:etiology / Q000517:prevention & control*; D005135:Eye Protective Devices / Q000592:standards*; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D007834:Lasers / Q000009:adverse effects*; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D012015:Reference Standards