Recommendation on the use of protective eyewear in endourological laser procedures

This work examines the current evidence available regarding the risks of eye injury in endourology laser environments with the aim of providing a consensus recommendation on the appropriate use of protective eyewear.

A working group was set up consisting of urological surgeons and laser protection advisors. A literature review was conducted to identify articles relevant to endourology practice and the commonly used lasers, and these were reviewed by the working group. Searches of the medical device fault/reporting databases were also undertaken. A consensus was developed and shared with stakeholders.

No reports of eye injuries from Ho:YAG, Tm:YAG, or Thulium Fibre Lasers (TFLs) were identified, although reports of skin burns and equipment-related fires were found. Available evidence suggests that ocular risks in endourology from these lasers are minimal and limited to rare cases of reversible corneal damage. Protective eyewear can further reduce this risk. However, Lasers with wavelengths below 1400 nm pose significant ocular risks, including blindness.

Personnel working in an endourology environment using Ho:YAG, Tm:YAG, or TFLs face minimal ocular risks when adhering to established safety procedures, and laser-specific eyewear may not always be essential. This requires an understanding of the hazards and risks and is in accordance with the recommendations herein, which should form the basis for relevant local rules. Protective eyewear remains critical when using visible and near-infrared lasers due to the heightened associated ocular risks.