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Scientific Articles   |    
Leaded Eyeglasses Substantially Reduce Radiation Exposure of the Surgeon’s Eyes During Acquisition of Typical Fluoroscopic Views of the Hip and Pelvis
Sean Burns, MD1; Raymond Thornton, MD2; Lawrence T. Dauer, PhD, CHP2; Brian Quinn, MS2; Daniel Miodownik, BA2; David J. Hak, MD, MBA3
1 Concord Orthopaedics, P.A., 264 Pleasant Street, Concord, NH 03301. E-mail address: progress@limbrestore.com
2 Interventional Radiology Service, Department of Radiology (R.T.); Department of Medical Physics, Radiation Safety Service Department (L.T.D., B.Q., and D.M.); and Department of Radiochemistry and Imaging Science Service (L.T.D.), Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065
3 Denver Health, 777 Bannock Street, MC 0188, Denver, CO 80204
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Investigation performed at Memorial Sloan-Kettering Cancer Center, New York, NY



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Jul 17;95(14):1307-1311. doi: 10.2106/JBJS.L.00893
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Abstract

Background: 

Despite recommendations to do so, few orthopaedists wear leaded glasses when performing operative fluoroscopy. Radiation exposure to the ocular lens causes cataracts, and regulatory limits for maximum annual occupational exposure to the eye continue to be revised downward.

Methods: 

Using anthropomorphic patient and surgeon phantoms, radiation dose at the surgeon phantom’s lens was measured with and without leaded glasses during fluoroscopic acquisition of sixteen common pelvic and hip views. The magnitude of lens dose reduction from leaded glasses was calculated by dividing the unprotected dose by the dose measured behind leaded glasses.

Results: 

On average, the use of leaded glasses reduced radiation to the surgeon phantom’s eye by tenfold, a 90% reduction in dose. However, there was widespread variation in the amount of radiation that reached the phantom surgeon’s eye among the various radiographic projections we studied. Without leaded glasses, the dose measured at the surgeon’s lens varied more than 250-fold among these sixteen different views.

Conclusions: 

In addition to protecting the surgeon’s eye from the deleterious effects of radiation, the use of leaded glasses could permit an orthopaedist to perform fluoroscopic views on up to ten times more patients before reaching the annual dose limit of 20 mSv of radiation to the eye recommended by the International Commission on Radiological Protection. Personal safety and adherence to limits of occupational radiation exposure should compel orthopaedists to wear leaded glasses for fluoroscopic procedures if other protective barriers are not in use.

Clinical Relevance: 

Leaded glasses are a powerful tool for reducing the orthopaedic surgeon’s lens exposure to radiation during acquisition of common intraoperative fluoroscopic views.

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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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