Preconceived Impressions Regarding Holmium:YAG Laser Safety in the Urology Operating Theatre

Figures & data

Table 1 Laser Safety Survey Parts and Questions

	Question	Optional Answers
Part One	1 – Please select your role	Theatre nurse Anaesthetic consultant Anaesthetic registrar Anaesthetic technician Urology consultant Urology registrar Other with the option to specify role
	2 – Have you done laser safety training?	Yes No
	3 – How many urological procedures using Holmium laser have you participated in?	None 1–5 6-20 More than 20
	4 – Eye damage can occur by looking into the “green light beam” even if the laser is not activated?	True False
	5 – Normal prescription glasses protect against eye damage?	True False
	6 – If the laser fibre is activated and there is no intervening barrier (no fluid or solid), what is the minimum distance to avoid injury?	0.4cm 5cm 30cm 1m 5m
	7 – Do you find that laser safety glasses impair your vision?	Yes No
	8 – Based on the hazard posed by Holmium laser, how would you classify the current laser safety requirements?	Insufficient Adequate Excessive
Part two	Summary and Recommendations from CUA (Table 2)
Part three	1 – After reading the summary and recommendations, how would you classify the current laser safety requirements?	Insufficient Adequate Excessive
	2 – If the use of laser safety glasses was optional would you choose to wear them?	Yes No

Table 2 Recommendations on Ho:YAG Laser Safety by the Canadian Urological Association

1	After over 20 years of extensive use, no eye injuries have ever been reported with the Ho:YAG laser.
2	Based on recent experimental data, it is evident that there is no damage to the unprotected eye unless the laser is fired very close to the eye (within 5 cm of the cornea).
3	Current evidence does not support mandatory safety eyewear for all personnel.
4	For operating surgeons who may already be wearing prescription glasses, laser goggles over glasses lead to significant visual impairment and could affect the surgeons ability to identify important visual cues.
5	Standard prescription eyeglasses are as protective as laser safety goggles.
6	Those who do not wear prescription glasses and may be in close proximity to the laser fibre (within 5cm) may wish to consider protective eyewear.

Note: Reprinted with permission from Bhojani N, Andonian S, Watterson JD, et al. Canadian urological association best practice report: holmium:YAG laser eye safety. Can Urol Assoc J. 2020;14(12):380–382.⁵

Figure 1 Responses to the above question “Eye damage can occur by looking into the green light beam even if the laser is not activated” expressed as a percentage of True/False.

Figure 2 Responses to the above question “Normal prescription glasses protect against laser induced eye damage” expressed as a percentage of True/False.

Figure 3 Responses to the above question “If the laser fibre is activated and there is no intervening barrier (no fluid or solid) what is the minimum distance to avoid injury?” represented as a percentage of total answers.

Figure 4 Responses to the above question “Do you find that the laser protection glasses impair your vision?'” represented as a percentage of Yes/No answers.

Figure 5 Responses to the above question “Based on the hazard posed by the holmium laser, how would you classify the current laser safety requirments?” represented as a percentage of Yes/No answers.

Figure 6 Responses to the above question “After reading the summary and recommendations, how would you classify the current laser safety requirements?” represented as a percentage.

Figure 7 Responses to the above question “If the use of laser safety goggles was optional would you choose to wear them?” represented as a percentage.

Bhojani N, Andonian S, Watterson JD, et al. Canadian urological association best practice report: holmium:YAG laser eye safety. Can Urol Assoc J. 2020;14(12):380–382. doi:10.5489/cuaj.6941

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