Radiation Shielding Effect of Surgical Loupes Compared with Lead-Lined Glasses and Plastic Face Shields.
| Title: | Radiation Shielding Effect of Surgical Loupes Compared with Lead-Lined Glasses and Plastic Face Shields. |
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| Authors: | Hardacker K; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island.; Hardacker P; Indiana University School of Medicine, Indianapolis, Indiana.; Callanan T; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island.; Daniels A; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island.; Bacic J; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island.; Schilkowsky R; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island.; Oumano M; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island.; Kuris E; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island. |
| Source: | The Journal of bone and joint surgery. American volume [J Bone Joint Surg Am] 2025 May 07; Vol. 107 (9), pp. e43. Date of Electronic Publication: 2025 Mar 20. |
| Publication Type: | Journal Article; Comparative Study |
| Language: | English |
| Journal Info: | Publisher: Journal of Bone and Joint Surgery Country of Publication: United States NLM ID: 0014030 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-1386 (Electronic) Linking ISSN: 00219355 NLM ISO Abbreviation: J Bone Joint Surg Am Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Boston, MA : Journal of Bone and Joint Surgery |
| MeSH Terms: | Radiation Protection*/instrumentation ; Occupational Exposure*/prevention & control ; Radiation Exposure*/prevention & control ; Eye Protective Devices*; Fluoroscopy/adverse effects ; Humans ; Lead ; Radiation Dosage ; Plastics |
| Abstract: | Background: Fluoroscopy plays a crucial role in various medical procedures, especially in orthopaedic and spinal surgery. However, concerns have arisen regarding ocular radiation exposure given its association with posterior lens opacities and cataracts. Protective measures are essential to mitigate ocular radiation exposure. During spine surgery, loupes are frequently used but often lack lead lining. The purpose of the present study was to assess the effect of surgical loupes, as compared with lead glasses and plastic face shields, on ocular radiation exposure.; Methods: Dosimeters were positioned anterior (unshielded) and posterior (shielded) to the lens of each type of eyewear: lead glasses, surgical loupes, and plastic face shields. Eyewear/dosimeters were exposed directly to the horizontal beam of a C-arm for 2 minutes of continuous fluoroscopy. This was repeated 20 times for each type of eyewear (40 total/eyewear, 120 times overall). Radiation doses were modeled with use of generalized estimating equations with a Gaussian distribution and identity link function. Separate models were employed for each outcome, including eyewear category (lead glasses, loupes, plastic shield) and dosimeter position (anterior/unshielded versus posterior/shielded).; Results: Radiation dose was significantly lower in posterior compared with anterior dosimeters for lead glasses (0.00 versus 1,689.80 mRem; p < 0.001) and for loupes (20.27 versus 1,705.95 mRem; p < 0.001). The difference for plastic face shields did not reach significance (1,539.75 versus 1,701.45 mRem; p = 0.06). Lead glasses offered the most protection, followed by surgical loupes and then plastic shields, when comparing the shielded dosimeter readings (0.00 versus 20.27 versus 1,539.75; p < 0.001 for all comparisons). There was no significant difference in radiation dose for dosimeters placed anterior to lead glasses, loupes, and plastic face shields (1,689.80 versus 1,705.95 versus 1,701.45 mRem; p = 0.99).; Conclusions: Lead glasses were most effective (∼100% reduction), followed by surgical loupes (97%), whereas plastic face shields showed no significant reduction in radiation dose. Surgical loupes can substantially reduce ocular radiation exposure.; Clinical Relevance: Surgical loupes may offer ocular radiation protection.; (Copyright © 2025 by The Journal of Bone and Joint Surgery, Incorporated.) |
| Competing Interests: | Disclosure: No external funding was received for this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article ( http://links.lww.com/JBJS/I496 ). |
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| Substance Nomenclature: | 2P299V784P (Lead); 0 (Plastics) |
| Entry Date(s): | Date Created: 20250320 Date Completed: 20250507 Latest Revision: 20250509 |
| Update Code: | 20260130 |
| DOI: | 10.2106/JBJS.24.00642 |
| PMID: | 40112043 |
| Database: | MEDLINE |
Journal Article; Comparative Study