Radiation-associated Lens Opacities in Catheterization Personnel: Results of a Survey and Direct Assessments

Purpose: To estimate ocular radiation doses and prevalence of lens opacities in a group of interventional catheterization professionals and offer practical recommendations based on these findings to avoid future lets damage. Materials and Methods: Subjects included 58 physicians and 69 nurses and technicians attending an interventional cardiology congress and appropriate unexposed age-matched controls. Lens dose estimates were derived from combining experimental measurements in catheterization laboratories with questionnaire responses regarding workload, types of procedures, and use of eye protection. Lens opacities were observed by dilated slit lamp examination using indirect illumination and retroillumination. The frequency and severity of posterior lens changes were compared between the exposed and unexposed groups. The severity of posterior lens Changes was correlated with cumulative eye dose. Results: Posterior subcapsular lens changes characteristic of ionizing radiation exposure were found in 50% of interventional cardiologists and 41% of nurses and technicians compared with findings of similar lens changes in < 10% of controls. Estimated cumulative eye doses ranged from 0.1-18.9 Sv. Most lens injuries result after several years of work without eye protection. Conclusions: A high prevalence of lens changes likely induced by radiation exposure in the study population suggests an urgent need for improved radiation safety and training, use of eye protection during catheterization, procedures, and improved occupational dosimetry.