Germicidal lamps that emit primarily 254 nm ultraviolet radiation (UV) are routinely utilized for surface sterilization but cannot be used for human skin because they cause genotoxicity. As an alternative, 222‐nm UVC has been reported to exert sterilizing ability comparable to that of 254‐nm UVC without producing cyclobutane pyrimidine dimers (CPDs), the major DNA lesions caused by UV. However, there has been no clear evidence for safety in chronic exposure to skin, particularly with respect to carcinogenesis. We therefore investigated the long‐term effects of 222‐nm UVC on skin using a highly photocarcinogenic phenotype mice that lack xeroderma pigmentosum complementation group A ( Xpa ‐) gene, which is involved in repairing of CPDs. CPDs formation was recognized only uppermost layer of epidermis even with high dose of 222‐nm UVC exposure. No tumors were observed in Xpa ‐knockout mice and wild‐type mice by repetitive irradiation with 222‐nm UVC, using a protocol which had shown to produce tumor in Xpa ‐knockout mice irradiated with broad‐band UVB. Furthermore, erythema and ear swelling were not observed in both genotype mice following 222‐nm UVC exposure. Our data suggest that 222‐nm UVC lamps can be safely used for sterilizing human skin as far as the perspective of skin cancer development.
All the 560 glaucomatous eyes of 375 Japanese subjects (181 men, 194 women; mean age ± standard deviation, 76.0 ± 13.2 years) who underwent microhook ab interno trabeculotomy (µLOT) alone (159 eyes, 28%) or combined µLOT and cataract surgery (401 eyes, 72%) performed by one surgeon at Matsue Red Cross Hospital between May 2015 and March 2018 to control intraocular pressure (IOP) were retrospectively assessed. Preoperative and postoperative IOPs, numbers of antiglaucoma medications, the logarithm of the minimum angle of resolution visual acuity (logMAR VA), anterior chamber (AC) flare, visual field mean deviation (MD), and corneal endothelial cell density (CECD) were compared up to 36 months. Surgical complications and required interventions were described. The duration of the follow-up was 405 ± 327 (range, 2–1326) days. The mean preoperative IOP (20.2 ± 7.0 mmHg) and number of antiglaucoma medications (2.8 ± 1.1) decreased to 13.9 ± 4.5 mmHg (31% reduction, p < 0.0001) and 2.5 ± 1.0 (11% reduction, p < 0.0001), respectively, at the final visit. After combined surgery, compared with preoperatively, the final VA improved 0.11 logMAR (p < 0.0001), AC flare increased 4.5 photon counts/msec (p = 0.0011), MD improved 0.6 decibel (p < 0.0001), and the CECD decreased 6% (p < 0.0001). Layered hyphema (172 eyes, 31%) and hyphema washout (26 eyes, 5%) were the most common postoperative complication and intervention, respectively. At the final visit, 379 (69%) eyes achieved successful IOP control of ≤18 mmHg and ≥20% IOP reduction, and 349 (64%) eyes achieved successful IOP control of ≤15 mmHg and ≥20% IOP reduction. Older age, steroid-induced glaucoma, developmental glaucoma, and the absence of postoperative complications were associated with lower final IOP; exfoliation glaucoma, other types of glaucoma, and higher preoperative IOP were associated with higher final IOP. µLOT has a significant IOP-lowering potential in patients with glaucoma, and improves visual function when combined with cataract surgery.
Corneal damage-induced various wavelength UV (311, 254, 235, 222 and 207 nm) was evaluated in rats. For 207 and 222-UV-C, the threshold radiant exposure was between 10 000 and 15 000 mJ cm À2 at 207 nm and between 3500 and 5000 mJ cm À2 at 222 nm. Penetrate depth to the cornea indicated by cyclobutene pyrimidine dimer (CPD) localization immediately after irradiation was dependent on the wavelength. 311 and 254 nm UV penetrate to corneal endothelium, 235 nm UVC to the intermediate part of corneal stroma, 222 and 207 nm UVC only to the most outer layer of corneal epithelium. CPD observed in corneal epithelium irradiated by 222 nm UVC disappeared until 12 h after. The minimum dose to induce corneal damage of short-wavelength UV-C was considerably higher than the threshold limit value (TLV â ) promulgated by American Conference of Governmental Industrial Hygienists (ACGIH). The property that explains why UV-C radiation at 207 and 222 nm is extremely less hazardous than longer UV wavelengths is the fact that this radiation only penetrates to the outermost layer of the corneal epithelium. These cells typically peel off within 24 h during the physiological turnover cycle. Hence, short-wavelength UV-C might be less hazardous to the cornea than previously considered until today.
Two krypton‐chloride germicidal excimer lamp units (Care222 TRT‐104C11‐UI‐U3, USHIO Inc.) were installed in the examination room of an ophthalmology department. The irradiation dose was set not to exceed the former (i.e., before 2022) threshold limit value (TLV) (22 mJ cm−2/8 h) recommended by the ACGIH. Section 1: The eyes and lids of the six ophthalmologists (5 wore glasses for myopic correction) who worked in the room for a mean stay of 6.7 h week−1 were prospectively observed for 12 months. Slitlamp examinations revealed neither acute adverse events such as corneal erosion, conjunctival hyperemia, and lid skin erythema nor chronic adverse events such as pterygium, cataract, or lid tumor. The visual acuity, refractive error, and corneal endothelial cell density remained unchanged during the study. Section 2: The irradiation of samples placed on the table or floor using the same fixtures in the room (5–7.5 mJ cm−2) was associated with >99% inhibition of φX174 phage and >90% inhibition of Staphylococcus aureus. In conclusion, no acute or chronic health effects in human participants was observed in a clinical setting of full‐room ultraviolet germicidal irradiation by 222‐nm lamp units, and high efficacy in deactivation of microorganisms was determined in the same setting.
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