EYE PROTECTION

The ANSI standards and common sense dictate that the eyes of the operating room staff and the patient be protected during laser surgery. Errant infrared energy from a CO₂ laser can quickly cause a serious corneal injuiry,^[44] whereas argon, KTP:Nd:YAG, or ruby lasers may burn the retina.^[45] The lids of patients' nonoperated eyes should be taped closed and then covered with an opaque, saline-soaked knit or metal shield.^{[46] [47] [48]} Operating room personnel must wear safety goggles or lenses specific for the specific laser wavelength in use. Using the wrong filter provides no protection. Safety goggles should provide wraparound protection from reflected light. For CO₂ lasers, any clear glass or plastic lenses suffice because they are opaque to far infrared. Regular eyeglasses may be sufficient, but contact lenses are not. Other lasers require color filters whose wavelength specificity and optical density are regulated. Nd:YAG lasers require special green-tinted goggles, which make assessment of patient skin color difficult, or clear lenses (Nd:YAG Protection Glass, Surgical Laser Technologies, Malvern, PA), which have a special coating opaque to near infrared. Argon or krypton lasers require an amber-orange lens filter, and KTP:Nd:YAG lasers require a red filter. Because lasers other than the far-infrared CO₂ produce beams that pass through glass, all windows into the operating room should be covered during laser procedures and specific, specially designed warning signs should be posted as described in ANSI Z136.3.