1. Daniel Fung Kevin Burns
The effect of radiation protection eyewear frame style on operator lens dose
Daniel Fung
Kevin Burns

2. Disclosures
Dr. Fung has no affiliation or financial interest which should be disclosed
Dr. Burns has no affiliation or financial interest which should be disclosed

3. Background
In 2011, ICRP changed the occupational limit from 150mSv to 20mSv for the lens of the eye1
Increased risk of cataracts in personnel working in the interventional suite2
Multiple studies have shown significant reduction of radiation lens dose while wearing leaded eyewear3,4
There are no current studies that compare the different types of radiation protection eyewear
Recent changes in our understanding of safe lens dose
Many articles saying the benefits of lead glasses, but no direct comparison!

4. Objective
To determine which radiation protection eyewear frame is most effective at reducing operator lens dose

5. Materials & Methods 16 different radiation protection eyewear
Fit-over glasses (FG)
Wrap-around glasses (WG)
Standard glasses (SG)
Tested in two different operator positions, Neck and Groin, using:
Fluoroscopy (78 kVP, 8 mA)
DSA (95 kVp, 23 mA)
Dose was recorded using DoseView (Philips Healthcare)
Height from floor to top of skin cm
Patient torso thickness - 17cm
Detector patient skin surface - 3cm
Patient skin center to IR eye - 72cm

6. Materials & Methods
Model #
Type
Lens Width
Lens Height
Side Shield #1
RG-33
Fitover 62 40
Yes #2
RG-554
Normal 52 36 #3
RG-1205
Wrap-around 64 35 No #4
RG-208 #5
RG-EGM 50 30 #6
RG-320 34 #7
RG-70PC-S 48 42 #8
RG-70PC+S #9
RG-375
#10
RG-MX30 53 32
#11
RG-533 65
#12
RG-206 33
#13
RG-703 59
#14
Rayshield SportsWrap
#15
Nike Brazen 60
#16
WileyX P17 38
We were blinded during the study and tested them randomly as to limit bias
Missing Rayshield SportsWrap lens width and lens height as the manufacturer has not provided the information

7. Materials & Methods
Left: Brazen
Right: RG-1205

8. Left: RG-208
Right: RG-206

9. Left:??? RG-375
Right: RG-703

10. Left: Neck Access
Right: Groin Access

11. Results - Groin Access
Model #
Type
2min Fluoro mSv/h
1min DSA mSv/h
95%CI
No Eyewear
Control
0.0747
0.5838
Ray Ban Sunglasses
0.0603
0.6342
RG-33
Fitover UD
0.063
RG-70PC-S
Normal
0.0624
RG-70PC+S
0.0654
RG-206
0.1062
RG-320
0.0876
RG-375
0.0888
RG-554
0.0678
RG-208
Wrap-around
0.0798
RG-533
RG-703
0.0612
RG-1205
0.072
RG-EGM
0.1038
RG-MX30
0.0618
Nike Brazen
WileyX P17
0.0744
Rayshield SportsWrap
0.1002
BLUE = statistically significant as it was above the CI
RED = statistically significant as it was below the CI

12. Results - Neck Access
Model #
Type
2min Fluoro mSv/h
1min DSA mSv/h
95% CI 0.17 to 0.21
No Eyewear
Control
0.1314
1.707
Ray Ban Sunglasses
0.1305
1.713
RG-33
Fitover UD
0.2448
RG-70PC-S
Normal
0.1566
RG-70PC+S
0.1788
RG-206
0.2340
RG-320
0.2262
RG-375
0.1986
RG-554
0.1758
RG-208
Wrap-around
0.1752
RG-533
0.1836
RG-703
0.1404
RG-1205
0.1782
RG-EGM
0.2646
RG-MX30
0.1668
Nike Brazen
0.1368
WileyX P17
0.1458
Rayshield SportsWrap
0.183
BLUE = statistically significant as it was above the CI
RED = statistically significant as it was below the CI

13. Results
Lead eyewear resulted in a 7 to 9 fold decrease in radiation dose vs. control
All lead glasses resulted in undetectable levels (<1µSv) during fluoroscopy
Frame Type
FG were lowest at groin: mSv/h
WG were lowest at neck: mSv/h
Individual Frames
RG-708 (WG) was lowest at groin ( mSv/h)
Nike Brazen (WG) was lowest at neck ( mSv/h)
Only 1 pair of fit-over glasses tested, as the sample size is small. The most effective pair of glasses were a pair of WG.
The larger lenses had the best radiation dose and the smaller lens had the worse radiation dose. This may also be due to the size of the DoseAware sensor.

14. Conclusions
Radiation protection eyewear is very important for the reduction of lens dose
Overall, wrap-around frames were found to be most effective at reducing radiation lens dose
Larger lens sizes led to better radiation reduction
Side shields had minimal effect on radiation dose based on one pair with detachable side shields

15. References
International Commission on Radiological Protection (ICRP). Statement on tissue reactions
Radiation-associated Lens Opacities in Catheterization Personnel: Results of a Survey and Direct Assessments. Vano, Eliseo et al. Journal of Vascular and Interventional Radiology , Volume 24 , Issue 2 ,
Comparing strategies for operator eye protection in the interventional radiology suite. RH Thornton, LT Dauer, et al. J Vasc Interv Radiol Nov; 21(11): 1703–1707.
Burns S, Thornton R, et al. Leaded Eyeglasses Substantially Reduce Radiation Exposure of the Surgeon's Eyes During Acquisition of Typical Fluoroscopic Views of the Hip and Pelvis. J Bone Joint Surg Am. 2013;95(14):1307–11. Jul 17.

16. Acknowledgements
Bill Brown from Phillips Safety for lending us the radiation glasses
Carol Cohen from CIRS for lending us the head phantom

17. Questions?