Br J Ophthalmol 2000;84:1372-1375
( December )
Endoillumination during vitrectomy and phototoxicity thresholds
Pieter R van den Biesen, T Berenschot, Rudolf M Verdaasdonk, Huib van Weelden, D van Norren
FC Donders Institute
of Ophthalmology, Department of Biomedical Engineering, and Institute
of Dermatology, University Hospital Utrecht, Utrecht, Netherlands
Correspondence to: Dr P R van den Biesen, FC Donders Institute of Ophthalmology,
University Hospital Utrecht, PO Box 85500, 3508 GA Utrecht, Netherlands
p.vdbiesen{at}oogh.azu.nl
Accepted for publication 26 May 2000
AIM To assess the
retinal phototoxicity hazards of and to provide safety margins for
endoillumination during vitrectomy.
METHODSThe 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.
RESULTSMeasurements
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.
CONCLUSIONCommercially
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.
© 2000 by British Journal of Ophthalmology
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