Endoillumination during vitrectomy and phototoxicity thresholds
Endoillumination during vitrectomy and phototoxicity thresholds
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DOI：
10.1136/bjo.84.12.1372
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发表时间：
2000-12-01
影响因子：
4.1
通讯作者：
van Norren, D
中科院分区：
文献类型：
--
作者：
van den Biesen, PR;Berenschot, T;van Norren, D
目的-评估玻璃体切除术期间内照明的视网膜光毒性危害并提供安全裕度。方法-测量可用于玻璃体手术的各种光源和滤光片组合的绝对功率和光谱分布。根据ICNIRP安全指南计算无晶状体眼光化学和热损伤的最大暴露时间。此外，还评估了降低光毒性风险的各种措施的效果。结果 - 光谱和能量测量表明，测试的 10 种组合中有 9 种在 1 分钟内超出了 ICNIRP 光化学视网膜损伤安全指南。通过额外的 475 nm 长通滤光片、低于 10 mW 的光水平以及光探头到视网膜的距离至少 10 mm，允许的曝光时间可增加至 13 分钟。当光探头接触视网膜时，可以预见到热损伤。结论-玻璃体切除术期间用于内照明的市售光源对于光化学视网膜损伤是不安全的。即使采取最大程度的预防措施，黄斑光毒性损伤仍然是玻璃体切除术中的一个实际危险。
Aim-To assess the retinal phototoxicity hazards of and to provide safety margins for endoillumination during vitrectomy.Methods-The absolute power and spectral distribution from various light sources and filter combinations that are commercially available for vitreous surgery were measured. The maximal exposure times based on the ICNIRP safety guidelines for photochemical and thermal injury of the aphakic eye were calculated. Additionally, the effect of various measures that reduce the risk of phototoxicity was evaluated.Results-Measurements of the spectrum and energy indicated that the ICNIRP safety guidelines for photochemical retinal damage are exceeded within 1 minute for nine out of 10 combinations tested. With an additional 475 nm long pass filter, light levels below 10 mW, and a distance from light probe to retina of at least 10 mm, the allowable exposure time can be increased up to 13 minutes. Thermal damage can be anticipated when the light probe touches the retina.Conclusion-Commercially available Light sources for endoillumination during vitrectomy are not safe with respect to photochemical retinal damage. Even with maximal precautions macular phototoxic damage remains a factual danger during vitrectomy.