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.

1.
Health and Safety Commission,
Management of Health and Safety at Work Regulations 1999
, HSE Books, Sudbury, ISBN 0 7176 2488 9.
2.
A.J.
Lowe
. &
J.B.
O’Hagan
. (
2001
)
A Risk Assessment Methodology for the Use of Lasers in Healthcare Facilities (1103)
, in Proceedings of the
International Laser Safety Conference
,
San Diego, California, USA
.
3.
Spectra Gases. Material safety data sheet (1201)
4.
Agency for Toxic Substances and Disease Registry (ATSDR).
Toxicological Profile for Fluorides, hydrogen fluoride, and fluorine
(
2003
).
5.
Health and Safety Executive,
Workplace Exposure Limits
(
2005
), EH40/2005
6.
Health and Safety Executive,
Safe use of gas cylinders
, Issue
1
(
2004
)
7.
MHRA Device Bulletin DB2008 (03), Guidance on the safe use of lasers, intense light source systems, and LEDs in medical, dental, surgical and aesthetic practices.
8.
Agency for Toxic Substances and Disease Registry
.
(ATSCR), Toxicological Profile for Aluminum
(
2008
).
9.
Health and Safety Executive, Ozone: Health Hazards and Precautionary Measures, Guidance Note EH38
This content is only available via PDF.
You do not currently have access to this content.