Non-beam hazards of the ophthalmic excimer laser

Abstract

The excimer laser, with a gas mixture of argon and fluorine, is widely used in refractive eye surgery. Over the past decade the excimer laser has become the preferred choice for treatment; the ultraviolet laser beam at 193 nm is able to remove microscopic amounts of tissue from the cornea via a photochemical interaction, resulting in a huge improvement in results from refractive eye surgery compared with previous techniques.The use of the excimer laser for ophthalmic surgery introduces a number of hazards, many being non-beam hazards. These non-beam hazards are discussed, and include: fluorine gas, which forms part of the laser active medium, laser plume, high voltage power supply, electromagnetic interference and ozone.It is concluded that the most significant non-beam hazard is fluorine gas. Basic gas law calculations indicate that a fluorine gas leak in an ophthalmic clinic may cause exposure limit values to be exceeded. An incident at an ophthalmic clinic involving a fluorine gas leak highlights the need for a risk assessment to be conducted and contingency plans to be put into place.The excimer laser, with a gas mixture of argon and fluorine, is widely used in refractive eye surgery. Over the past decade the excimer laser has become the preferred choice for treatment; the ultraviolet laser beam at 193 nm is able to remove microscopic amounts of tissue from the cornea via a photochemical interaction, resulting in a huge improvement in results from refractive eye surgery compared with previous techniques.The use of the excimer laser for ophthalmic surgery introduces a number of hazards, many being non-beam hazards. These non-beam hazards are discussed, and include: fluorine gas, which forms part of the laser active medium, laser plume, high voltage power supply, electromagnetic interference and ozone.It is concluded that the most significant non-beam hazard is fluorine gas. Basic gas law calculations indicate that a fluorine gas leak in an ophthalmic clinic may cause exposure limit values to be exceeded. An incident at an ophthalmic clinic involving a fluorine gas leak highlights the n...