Vol.:(0123456789) Radiological Physics and Technology https://doi.org/10.1007/s12194-018-0487-9 Risk of radiation-induced lens opacities among surgeons and interventional medical staf Luca Coppeta 1  · Antonio Pietroiusti 1  · Anna Neri 1  · Agostino Spataro 1  · Elisabetta De Angelis 1  · Stefano Perrone 1  · Andrea Magrini 1 Received: 10 January 2018 / Revised: 21 October 2018 / Accepted: 1 November 2018 © Japanese Society of Radiological Technology and Japan Society of Medical Physics 2018 Abstract The main efect of ionizing radiation on the eyes is the onset of posterior cortical and subcapsular cataracts. Recent studies have raised questions about the mechanism of ocular damage and the threshold dose for the onset of such efects. Currently, operators may be exposed to ionizing radiation during surgical procedures. It has been estimated that urologists can be exposed to an annual dose close to or above 20 mSv/year. The aim of our study was to evaluate the frequency of cataracts in a group of professional radiological operators to verify their possible association with the radiation dose to the crystalline lens and the tasks performed. The records of 73 health workers exposed to ionizing radiation were reviewed. The average annual dose to the crystalline lens, the number of years of exposure, and the presence of radiation-compatible opacities were assessed for all operators. Lenticular opacities were observed in 16.4% of subjects. The presence of alterations was associated with exposure doses below 10 mSv and > 10 years’ experience in fuoroscopically guided procedures. Based on our results, protection of the crystalline lens against exposure to ionizing radiation by means of goggles is recommended. In addition, examination of the lens via slit lamp examination is recommended for all operators involved in interventional procedures with the current levels of radiation exposure. Keywords Lens opacities · Ionizing radiation · Occupational cataract · Occupational exposure · Interventional radiology · Radiation protection 1 Introduction The main efect of ionizing radiation on the eye is the loss of transparency of the lens, as documented by studies on sur- vivors of the atomic explosions of Hiroshima and Nagasaki [1, 2]. The pathogenic mechanisms leading to this alteration are well-known and involve direct changes in the lenticular cells, which, due to the particular architecture of the tissue, are easily damaged. This results in specifc alterations in the cells’ water and protein content, accompanied by varia- tions in the ability to conduct optical radiation. Many factors afect the tissue response to radiation, including the type of radiation, the manner of exposure, the individual genetic susceptibility, and the forms of cataracts with respect to the visual axis [3, 4]. The onset of cataracts is considered to be a deterministic having a threshold dose below which the efect does not occur [2]. The relationship between exposure to high doses of radiation > 2 Gy and the onset of lenticu- lar opacities has been well-documented in the literature for many years [2, 3]. However, reports on the possibility of damage at low doses of exposure are relatively recent, as are the assumptions regarding the absence of an efect threshold [5, 6]. Epidemiological studies performed so far indicate a positive association between exposure to ionizing radiation and posterior subcapsular, cortical, and mixed cataracts at diferent levels of exposure. The main imitations of these studies are the short observation period and the experimen- tal models used. In fact, it is not possible to identify with certainty an efect threshold for acute and chronic exposures [7]. Recent studies have shown a greater frequency of len- ticular opacity among health professionals exposed for many years to relatively low doses of ionizing radiation during the course of vascular procedures, and also for expo- sure below the occupational exposure limit established by * Luca Coppeta lcoppeta@gmail.com 1 Department of Occupational Medicine, University of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy