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Scattered ultraviolet emissions during refractive surgery using a high-frequency, wavefront-optimized excimer laser

Kraig S Bower¹, Jayson D Edwards, Denise Sediq Ryan

¹Ophthalmology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. kraig.bower@amedd.army.mil

Journal of Cataract and Refractive Surgery

|July 27, 2010

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Occupational ultraviolet (UV) exposure during laser eye surgery was measured. While higher than some systems, UV levels from the Allegretto Wave Eye-Q excimer laser remained below safety limits for personnel.

Area of Science:

Ophthalmology
Laser Surgery
Occupational Health

Background:

Photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) are common refractive surgeries.
Excimer lasers are used in these procedures, emitting ultraviolet (UV) radiation.
Assessing occupational UV exposure is crucial for operating room safety.

Purpose of the Study:

To quantify intraoperative ultraviolet (UV) radiation exposure during PRK and LASIK procedures.
To evaluate exposure levels using the Allegretto Wave Eye-Q 400 Hz excimer laser.
To compare measured UV exposure with established occupational safety limits.

Main Methods:

UV measurements were taken during PRK (with brush or ethanol epithelial removal) and femtosecond LASIK.

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A LaserStar power meter recorded maximum pulse energy at 25.4 cm from the cornea.

Exposure was assessed in a worst-case scenario for operating room personnel.

Main Results:

Mean maximum exposure per pulse varied: 129.38 nJ/pulse (brush PRK), 69.72 nJ/pulse (ethanol PRK), and 29.17 nJ/pulse (LASIK).
Mean maximum exposure per eye was 0.085 mJ/cm², 0.046 mJ/cm², and 0.01 mJ/cm², respectively.
Worst-case cumulative daily exposure for 40 eyes was calculated as 3.92 mJ/cm² (brush PRK), 1.51 mJ/cm² (ethanol PRK), and 0.79 mJ/cm² (LASIK).

Conclusions:

The Allegretto Wave Eye-Q excimer laser system may result in higher UV exposure compared to older systems.
Despite potentially higher levels, UV exposure during these procedures did not exceed occupational safety limits set by the International Commission on Non-Ionizing Radiation Protection.
These findings support the safe use of this excimer laser platform in refractive surgery settings.