Abstract：
BACKGROUND: The annual dose limit for radiation exposure to the eye has been reduced recently; the eye is widely recognised as one of the most radiosensitive tissues in the body. There is minimal good quality research as to the radiation dose that the eye receives during endourological surgery and this study aimed to address this.
METHODS: A prospective study was performed over an 8-month period at a single large teaching hospital in the UK. Three index procedures were included: ureteric stent insertion, ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL). Surgeons wore a dosimeter on the glabella with fluoroscopy time (FT) and dose area product (DAP) recorded for each case.
RESULTS: A total of 404 procedures were included (247 URSs, 150 ureteric stent insertions and 7 PCNLs). Dosimeters were worn by ten surgeons. Mean FTs (URS 20.56s; ureteric stent 18.96s; PCNL 360.67s) and mean DAP (URS 100.82cGy/m2, ureteric stent 119.82cGy/m2 and PCNL 1121.62cGy/m2) were identified with significant intersurgeon variability. No surgeon had a total dosimeter dose >0.00mSv.
CONCLUSIONS: The International Commission on Radiological Protection recently reduced the yearly eye dose limit from 150 to 20mSv. Cataractogenesis is no longer considered a typical deterministic effect, with a threshold level below which no effect occurs. Even in higher volume centres, these annual limits are unlikely to be reached. Lead glasses may be considered for surgeons and radiologists with the highest exposure but, for the majority, ocular radiation exposure is negligible.
METHODS: A prospective study was performed over an 8-month period at a single large teaching hospital in the UK. Three index procedures were included: ureteric stent insertion, ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL). Surgeons wore a dosimeter on the glabella with fluoroscopy time (FT) and dose area product (DAP) recorded for each case.
RESULTS: A total of 404 procedures were included (247 URSs, 150 ureteric stent insertions and 7 PCNLs). Dosimeters were worn by ten surgeons. Mean FTs (URS 20.56s; ureteric stent 18.96s; PCNL 360.67s) and mean DAP (URS 100.82cGy/m2, ureteric stent 119.82cGy/m2 and PCNL 1121.62cGy/m2) were identified with significant intersurgeon variability. No surgeon had a total dosimeter dose >0.00mSv.
CONCLUSIONS: The International Commission on Radiological Protection recently reduced the yearly eye dose limit from 150 to 20mSv. Cataractogenesis is no longer considered a typical deterministic effect, with a threshold level below which no effect occurs. Even in higher volume centres, these annual limits are unlikely to be reached. Lead glasses may be considered for surgeons and radiologists with the highest exposure but, for the majority, ocular radiation exposure is negligible.
摘要：
背景：最近降低了对眼睛的辐射暴露的年度剂量限制；眼睛被广泛认为是体内对辐射最敏感的组织之一。关于在腔内手术期间眼睛接受的辐射剂量的高质量研究很少，这项研究旨在解决这个问题。
方法：在英国一家大型教学医院进行了为期8个月的前瞻性研究。包括三个指标程序：输尿管支架插入，输尿管镜检查（URS）和经皮肾镜取石术（PCNL）。外科医生在labella上佩戴剂量计，并记录每种情况的荧光透视时间（FT）和剂量面积乘积（DAP）。
结果：共包括404个手术（247个URSs，150个输尿管支架插入和7个PCNL)。十位外科医生佩戴了剂量计。平均FTs（URS20.56s；输尿管支架18.96s；PCNL360.67s）和平均DAP（URS100.82cGy/m2，输尿管支架119.82cGy/m2和PCNL1121.62cGy/m2）被确定为具有明显的外科医生差异。没有外科医生的总剂量计剂量>0.00mSv。
结论：国际放射防护委员会最近将每年的眼睛剂量限制从150降至20mSv。白内障发生不再被认为是典型的确定性效应，具有阈值水平，低于该阈值水平不会发生影响。即使在数量较高的中心，这些年度限制不太可能达到。铅眼镜可能会被考虑用于暴露量最高的外科医生和放射科医生，但是，对于大多数人来说,眼部辐射暴露可以忽略不计。
方法：在英国一家大型教学医院进行了为期8个月的前瞻性研究。包括三个指标程序：输尿管支架插入，输尿管镜检查（URS）和经皮肾镜取石术（PCNL）。外科医生在labella上佩戴剂量计，并记录每种情况的荧光透视时间（FT）和剂量面积乘积（DAP）。
结果：共包括404个手术（247个URSs，150个输尿管支架插入和7个PCNL)。十位外科医生佩戴了剂量计。平均FTs（URS20.56s；输尿管支架18.96s；PCNL360.67s）和平均DAP（URS100.82cGy/m2，输尿管支架119.82cGy/m2和PCNL1121.62cGy/m2）被确定为具有明显的外科医生差异。没有外科医生的总剂量计剂量>0.00mSv。
结论：国际放射防护委员会最近将每年的眼睛剂量限制从150降至20mSv。白内障发生不再被认为是典型的确定性效应，具有阈值水平，低于该阈值水平不会发生影响。即使在数量较高的中心，这些年度限制不太可能达到。铅眼镜可能会被考虑用于暴露量最高的外科医生和放射科医生，但是，对于大多数人来说,眼部辐射暴露可以忽略不计。
