Laser reflections from surgical instruments

Abstract

The potential hazards to the eye and skin from accidental exposures caused by reflected laser beams from surgical instruments has long been of concern to operating room staff members. Reflectance values for argon neodymium:YAG and CO2 laser wave-lengths were measured from 29 reference surfaces used on surgical instruments. From these measurements, nominal hazard zones could be determined for typical reflection hazards.

Error Avoidance in Dermatologic Surgery

“…Corneal shields are recommended if the laser is being used on the face [59]. Laser beams can reflect off of mirrors or metal surfaces leading to damage of the eyes and skin [63]. These surfaces should be removed or covered before activation of the laser.…”

Eye Safety of Laser and Light-Based Devices

“…Even the so-called super-pulse laser is quasi-CW compared to single-pulse or multiply pulsed fractional laser systems. However, in some cases, combining a special black surface with roughening provides increased protection, and adding a black polymer finish to surgical implements placed in or near the beam has been shown by experiment measurements to offer the greatest protection at the CO, wavelength-despite initial skepticism by investigators [29]. This is particularly true of lasers operating in the retinal hazard region of the visible (400-780 nm) and near-infrared spectrum (IR-A, 780 to 1400 nm), as shown in Figs.…”

“…This results from the fact that the relative size of the microscopic structure of the surface relative to the incident wavelength determines whether the beam is reflected as a specular or diffuse reflection [1,14,29]. In fact, a roughened surface that appears to be quite dull and diffuse at a shorter, visible, or IR-A wavelengths, will always be more specular at far-infrared wavelengths (e.g., at 10.6 m).…”

“…Studies of plastic eye protectors show clearly that polycarbonate is far superior in burn-through resistance than other plastics, and such a marking has been argued to be quite justifiable for use with CO, lasers having a power output up to about 100 W [29]. Some Laser Safety Officers (LSOs) may be uneasy about marking eye protectors not sold as "laser" eye protection, because of perceived (or very real) legal concerns.…”

“…Some Laser Safety Officers (LSOs) may be uneasy about marking eye protectors not sold as "laser" eye protection, because of perceived (or very real) legal concerns. Goggles manufactured of special glass can frequently be designed to withstand irradiances higher than the -100 W/cm2 order-of-magnitude typically required to burn through polycarbonate lenses in 10 s [29]. In some countries, the marking of eye protection by anyone other than the manufacturer is not legally recognized, and the LSO has no alternative but to obtain similar polycarbonate eye protectors that have been certified and labeled by the manufacturer.…”