Comparison of Ocular Radiation Exposure Utilizing Three Types of Leaded Glasses

Spine (Phila Pa 1976). 2016 Feb;41(4):E231-6. doi: 10.1097/BRS.0000000000001204.

Abstract

Study design: Anthropomorphic phantoms were used to measure radiation exposure to the surgeon phantom's eye. Groups analyzed were: Group 1-no glasses (None); Group 2-leaded lenses without lead sides (WOLS); Group 3-leaded lenses with lead sides (WLS); and Group 4-sport wraparound leaded glasses (Sport). Glasses were 0.75 mm lead equivalent.

Objective: To evaluate the efficacy of three types of leaded eyeglasses at reducing radiation exposure to the lens during typical views of minimally invasive spine surgery.

Summary of background data: Minimally invasive spine surgery relies upon fluoroscopic x-ray. Ocular radiation exposure is associated with cataract formation. Leaded glasses can reduce ocular radiation exposure.

Methods: Fifteen individual 20-second exposures with the fluoroscopic C-arm in the anteroposterior (AP) and lateral positions, with phantom head positioned at 0, 45, and 90 degrees to the fluoroscope were performed. Radiation was measured using a solid-state dosimeter. Student t test was used to calculate significance.

Results: All glasses (WOLS, WLS, and Sport) had significant reductions in ocular radiation versus no glasses, at all individual head positions (P ≤ 1.31 × 10). Sport had significantly lower ocular radiation dose than WLS at all head positions except at 90 degrees AP (P = 0.001). WOLS had significantly lower ocular radiation dose than Sport in three out of six cases including phantom head at 0 degrees AP (P = 0.0003), 90 degrees AP (P = 4.46 × 10), and 90 degrees lateral (P = 7.38 × 10). WOLS had significantly lower radiation dosage at all head positions than WLS except at 45 degrees AP (P = 0.303). All glasses resulted in a significant reduction in total radiation dose from all head positions over no glasses (P ≤ 8.37 × 10).

Conclusion: We demonstrate a significant reduction in ocular radiation exposure with all three types of leaded glasses. Lead glasses, WOLS and Sport, were the most effective at reducing ocular radiation.

Level of evidence: 3.

MeSH terms

  • Eye / radiation effects
  • Eye Protective Devices*
  • Humans
  • Minimally Invasive Surgical Procedures / standards*
  • Phantoms, Imaging*
  • Radiation Dosage
  • Radiation Injuries / prevention & control
  • Radiation Protection / instrumentation*
  • Spine / surgery*