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

The development of interventional cardiology has led us to successfully treat injuries and angiographic situations increasingly complex. This goes along that often the length of procedures is increasing automatically leading to increased fluoroscopy time and film images.

The result, often unnoticed, is the possibility of the appearance of irradiation injuries in our patients or in ourselves. We must keep in mind that younger interventionists may develop opacities faster than the older ones. One of the most sensitive tissues to radiation is the lens. The radiation-induced damage occurs in the germinative zone where cells reproduce slowly over our lives. It is unclear why this damage occurs preferentially in the dorsal face of the lens. It is possible that this basal membrane at this level is thinner but the result is that the cells lose their uniformity and emit extensions that make them joined together. The result is the loss of transparency with less light path. The first stage of this with the opacities in different states and in its maximum degree become cataracts.

This article published this month in the Journal of Vascular Interventional Radiology has a dual advantage: has revealed the high frequency of this disease, not only for interventional cardiologists but also in the room staff that despite working farthest away from the X-ray tube, also have a high percentage of radiation-induced damage. Also allowed us to demonstrate that in the context of a SOLACI conference it is possible, besides the usual dynamics, to perform field work. 127 medical staff attendees were examined at SOLACI conference held in Buenos Aires in 2011. In addition to filling a form on which workload was stated, three ophthalmologists, one eye specialist in radiation injuries and a medical physicist also examined them. It was the first time that our own lens opacities could be demonstrated using a digital slit lamp. All this equipment was coordinated by the International Atomic Energy Agency (IAEA) and supported by SOLACI.

Importance of the frequency of radiation-induced opacities is such, that the International Commission on Radiological Protection (ICRP) has reduced occupational annual dose limit from 150 to 20 mSv in 2011. Become aware of the possibility of getting this type of radiation injuries should lead us to increase our care and to apply, we and room staff, all necessary radiation protection measures. Only then, we can proceed with a safe and continuous development.

Courtesy by Dr. Ariel Durán,

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