Assessing the safety of broken holmium laser fibers

We assessed the safety of a number of broken Holmium laser fibers by measuring irradiances present near open or broken fibers. Realistic hazard distances for Holmium laser systems are remarkably small and could be used provide better guidance on recommendation for laser eye protection that would be appropriate to wear for users of medical lasers. Concerns over the potential for accidental eye injuries resulting from accidental release or breakage of fibers during laser surgery have frequently lead to the recommended wear of laser eye protection by all surgical staff. Although safety standards recommend that laser eyewear use is mandatory only within the ''Nominal Hazard Zone," the determination of this zone or designating the entire surgical room as the NHZ frequently leads to controversy. This is particularly controversial when laser endoscopy is performed and eye exposure is not possible except for either a fiber break or by accidental removal when the laser is emitting. Indeed below certain laser powers, it is possible to justify eliminating any need to wear eye protection for endoscopic use. The measurements reveal that our LSO community has often be over-stating the risk from optical fiber breaks.