[Effect of X-ray protective visors on the eye lens dose during ureteroscopy].

Eye lens radiation exposure during fluoroscopy-guided interventional procedures may result in occupational radiation-induced cataracts. We evaluated the eye lens radiation doses and the protective effect of X‑ray protective visors during ureteroscopic procedures.

Eye lens doses were measured in front of and behind X‑ray protective visors using eye lens dosemeters during ureteroscopic procedures done by 4 different endourologic surgeons within a 12-week period. Background radiation dose, simultaneously measured with transport dosemeters, was subtracted. Measured eye lens doses below the detection limit of the eye lens dosemeters were adjusted to the detection limit of 0.028 mSv. Correlating the eye lens doses (ELD) to the dose-area-product (DAP) an ELD/DAP ratio was calculated. Applying this ELD/DAP ratio the potential reduction of the eye lens radiation dose was retrospectively calculated for all ureteroscopic procedures done within one year.

Within the 12-week period 76 ureteroscopies were done by the 4 endourologic surgeons. The accumulated eye lens radiation dose was 0.796 mSv in front of the X‑ray protective visors, and 0.338 mSv behind the X‑ray protective visors. Thus, the eye lens radiation exposure was reduced to at least 42% by using X‑ray protective visors. Considering the 215 documented ureteroscopies in our clinic in the year before starting the study, occupational radiation exposure to the eye lens would have been reduced by X‑ray protective visors from 4.090 to 1.737 mSv.

X‑ray protective visors can effectively reduce the radiation exposure to the eye lens during fluoroscopy-guided endourologic procedures and should be used especially by high-volume endourologic surgeons.

Der Urologe. Ausg. A. 2020 May 06 [Epub ahead of print]

G Zöller, V Konstanz, J Brönner, H Hödlmoser

Klinik für Urologie und Kinderurologie, Klinikum Bad Hersfeld, Seilerweg 29, 36251, Bad Hersfeld, Deutschland. ., Klinik für Urologie und Kinderurologie, Klinikum Bad Hersfeld, Seilerweg 29, 36251, Bad Hersfeld, Deutschland., Auswertungsstelle, Helmholtz Zentrum München, Otto-Hahn-Ring 6, 81739, München, Deutschland.