The eye of the endourologist: what are the risks? A review of the literature.

PURPOSE: During endourological procedures, the eye of the urologist is exposed to hazards such as contact with body fluids and irrigation solutions as well as laser injury, and X-ray radiation absorption. The resulting potential injuries and damages to the eye have not been summarily reviewed to date. The objective was to review the different risks of exposure to the eyes of urologists during endourological procedures. METHODS: The Medline database was searched for identification of studies on hazards to the eye of the endourologist. All articles published in English until September 2018 were considered. RESULTS: Twenty-three publications were included in this analysis. The incidence of eye contact with patient body fluids or irrigation solutions during endoscopic procedures ranged between 37.50 and 100%. Laser-induced eye injuries were reported in 37.9% of all kind of adverse events related to laser use in urology. The eye lens dose of radiation ranged from 0.04 to 1600 µSv per endourological procedures. CONCLUSIONS: While the risks of infection, laser injury, lens opacity and cataract are generally low, the wear of protective glasses is recommended. Lead glasses may protect against all these risks in case of Ho:YAG laser use with concomitant X-ray radiation. If Ho:YAG laser is used without any concomitant X-ray radiation, proper laser safety glasses or at least conventional eyeglasses should be recommended. When other types of laser are used, we recommend wearing laser eye protection glasses covering the adequate range of wavelength. For endourological procedures without laser use and X-ray radiation, specific protection devices such as goggles or face shields are recommended.