The eye of the endourologist: what are the risks? A review of the literature

Abstract

Purpose

During endourological procedures, the eye of the urologist is exposed to hazards such as contact with body fluids and irrigation solutions as well as laser injury, and X-ray radiation absorption. The resulting potential injuries and damages to the eye have not been summarily reviewed to date. The objective was to review the different risks of exposure to the eyes of urologists during endourological procedures.

Methods

The Medline database was searched for identification of studies on hazards to the eye of the endourologist. All articles published in English until September 2018 were considered.

Results

Twenty-three publications were included in this analysis. The incidence of eye contact with patient body fluids or irrigation solutions during endoscopic procedures ranged between 37.50 and 100%. Laser-induced eye injuries were reported in 37.9% of all kind of adverse events related to laser use in urology. The eye lens dose of radiation ranged from 0.04 to 1600 µSv per endourological procedures.

Conclusions

While the risks of infection, laser injury, lens opacity and cataract are generally low, the wear of protective glasses is recommended. Lead glasses may protect against all these risks in case of Ho:YAG laser use with concomitant X-ray radiation. If Ho:YAG laser is used without any concomitant X-ray radiation, proper laser safety glasses or at least conventional eyeglasses should be recommended. When other types of laser are used, we recommend wearing laser eye protection glasses covering the adequate range of wavelength. For endourological procedures without laser use and X-ray radiation, specific protection devices such as goggles or face shields are recommended.

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Authors

Contributions

SD: Protocol development, data collection and management, data analysis, manuscript writing/editing. MA: Data collection and management, data analysis, manuscript editing. LV: Data analysis, manuscript editing. MR-MH: Data analysis, manuscript editing. VDC: Data analysis, manuscript editing. EXK: Data analysis, manuscript editing. OT: Project development, data analysis, manuscript editing.

Corresponding author

Correspondence to Olivier Traxer.

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Conflict of interest

Prof. Olivier Traxer is a consultant for Coloplast, Rocamed, Olympus, EMS, Boston Scientific and IPG Medical. Dr. Steeve Doizi is a consultant for Boston Scientific and Coloplast. Dr. Marie Audouin, Luca Villa, Maria Rodríguez-Monsalve Herrero, Vincent De Coninck, Etienne Xavier Keller have no relevant conflict of interest to declare.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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No informed consents were necessary for this study, since no research directly involving human participants and/or animals was performed in this study.

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Doizi, S., Audouin, M., Villa, L. et al. The eye of the endourologist: what are the risks? A review of the literature. World J Urol 37, 2639–2647 (2019). https://doi.org/10.1007/s00345-019-02667-0

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Keywords

  • Endourology
  • Urology
  • Eye
  • Injury
  • Laser
  • Percutaneous nephrolithotomy
  • Radiation
  • Transurethral resection
  • Ureteroscopy