In 2022, the European Atomic Energy Community reduced the annual equivalent dose limit for the lens from 150 to 20 mSv/year, due to its association with cataracts at low radiation doses. Our aim was to estimate the radiation doses received by the lens during endourological procedures that may require fluoroscopy.
Multicenter study including prospective data of annual eye dosimeters between 2017-2020. Four endourologists used an eye dosimeter in endourological procedures that may require fluoroscopy (URS, RIRS and PCNL). Surgeon 1 and 2 wore leaded glasses; Surgeon 1 also used the ALARA protocol. Descriptive statistical analysis using SPSS 25.0 was conducted.
Surgeons 1, 2, 3 and 4 performed a median of 159, 586, 102 and 129 endourological procedures/year, respectively, for a total of 641, 2,340, 413 and 350 procedures between 2017 and 2020. The median annual dose of lens radiation exposure was 0.16, 1.18, 3.79 and 1.42 mSv per year, respectively, which corresponds to 0.001, 0.009, 0.024 and 0.012 mSv/procedure. The two surgeons who used leaded glasses registered a lower radiation dose/procedure (0.001 vs. 0.027). Similarly, the urologist who used the ALARA protocol registered the lowest lens radiation dose compared to the three surgeons who did not use it (0.001 vs. 0.023).
The endourologists who participated in this study successfully comply with current guidelines on radiation exposure to the lens. Registered eye lens radiation does not seem to be related to the number of procedures but rather the use of leaded glasses and the ALARA protocol. .
Journal of endourology. 2023 Jun 19 [Epub ahead of print]
Alejandra Bravo-Balado, Sofía Fontanet, Andreas Skolarikos, Ali Serdar Gozen, Bhaskar K Somani, Olivier Traxer, Athanasios Papatsoris, Agustín Ruiz Martínez, Etienne Xavier Keller, Amelia Pietropaolo, Senol Tonyali, Thomas Tailly, Francesco Esperto, Evangelos N Liatsikos, Andres Koey Kanashiro Azabache, Oriol Angerri, Esteban Emiliani
Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain, Department of Urology , Carrer de Cartagena 340, Barcelona, Spain, 08025; ., Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain, Department of Urology , Barcelona, Spain; ., University of Athens, 2nd Department of Urology, 6 LASKAREOS ST, NEA ZOI PERISTERI, Athens, Greece, 12137; ., SLK Kliniken, University of Heidelberg, Urology, Heilbronn, Germany; ., University Hospitals Southampton NHS Trust, Urology, Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland, SO16 6YD., Tenon Hospital, Assitance Publique-Hopitaux De Paris. Pierre Et Marie Curie University, Paris 6, Urology, 4 rue de la Chine, Paris, France, 75020; ., Barts and The London NHS Trust, Urology, St Bartholomew's Hospital, West Smithfiled, London, United Kingdom of Great Britain and Northern Ireland, EC1A 7BE., Hospital de la Santa Creu i Sant Pau, 16689, Radiophysics and Radioprotection Clinical Service, Barcelona, Catalunya, Spain; ., University Hospital Zürich, Department of Urology, Frauenklinikstrasse 10, Zurich, Switzerland, 8091; ., University Hospitals Southampton NHS Trust, Urology, 12 Anglesea road, Southampton, United Kingdom of Great Britain and Northern Ireland, SO15 5QJ., IRCCS Ospedale San Raffaele, 9372, Department of Urology, Milano, Lombardia, Italy; ., University Hospital Ghent, 60200, Department of Urology, Gent, Oost-Vlaanderen, Belgium; ., Campus Bio-Medico University, 9317, Urology, Via Alvaro del Portillo 21, Roma, Italy, 00155; ., University of Patras, 37795, 11 ARETIS GREKOU STR, FILOTHEI, Patras, Greece, 26504; ., Urology, Calle Sant Jaume, 209 -217, Calella, Barcelona, Calella, Barcelona, Spain, 08370., Fundació Puigvert, Department of Urology, Barcelona, Spain; ., Fundacio Puigvert, 16444, Urology , Cartagena 340-350, Barcelona, Cataluña, Spain, 08025.