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A comparison of ocular protective measures during carbon dioxide laser laryngoscopy
Neil Bhattacharyya1, Carol Richard
1Division of Otolaryngology and Department of Operating Room Nursing, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, USA. neiloy@massmed.org
Objective:
To determine the efficacy of various eye protection measures during carbon dioxide laser laryngoscopy.
Design:
A standard medical mannequin was equipped with indicator paper over the eyes and subjected to multiple passes of direct carbon dioxide laser beam contact at 400-mm focal length with powers ranging from 2.5 to 4.0 W during simulated laser microlaryngoscopy. Several different eye protection materials, including silk tape, paper tape, cloth tape, occlusive dressing, and eye pads, were used to cover the eyes and tested for their degree of protection against the laser beam. Thermal injuries were quantified and compared among these protective materials.
Setting:
Academic medical center.
Main Outcome Measure:
Degree of eye protection against the laser beam injury on a scale of 0 to 4.
Results:
The carbon dioxide laser beam at both 2.5 and 4.0 W produced considerable thermal damage to the indicator paper in the absence of any protective barrier. Among the adhesive protective barriers, moistened cloth tape was the most effective adhesive material against laser beam-induced thermal damage (P<.001). Silk tape and paper tape offered poor protection. Moist eye pads, although not adhesive and therefore unable to maintain eye closure, were very effective barriers against the laser beam. Dry paper tape and dry eye pads were imminently flammable.
Conclusion:
A combination of moistened cloth tape to maintain eye closure coupled with placement of well- moistened cotton-based eye pads over the tape provides excellent eye protection during carbon dioxide laser laryngoscopy.
