Color vision deficits and laser eyewear protection for soft tissue laser applications.

PURPOSE: Laser safety considerations require urologists to wear laser eye protection. Laser eye protection devices block transmittance of specific light wavelengths and may distort color perception. We tested whether urologists risk color confusion when wearing laser eye protection devices for laser soft tissue applications. MATERIALS AND METHODS: Subjects were tested with the Farnsworth-Munsell 100-Hue Test without (controls) and with laser eye protection devices for carbon dioxide, potassium titanyl phosphate (KTP), neodymium (Nd):YAG and holmium:YAG lasers. Color deficits were characterized by error scores, polar graphs, confusion angles, confusion index, scatter index and color axes. Laser eye protection device spectral transmittance was tested with spectrophotometry. RESULTS: Mean total error scores plus or minus standard deviation were 13+/-5 for controls, and 44+/-31 for carbon dioxide, 273+/-26 for KTP, 22+/-6 for Nd:YAG and 14+/-8 for holmium:YAG devices (p <0.001). The KTP laser eye protection polar graphs, and confusion and scatter indexes revealed moderate blue-yellow and red-green color confusion. Color axes indicated no significant deficits for controls, or carbon dioxide, Nd:YAG or holmium:YAG laser eye protection in any subject compared to blue-yellow color vision deficits in 8 of 8 tested with KTP laser eye protection (p <0.001). Spectrophotometry demonstrated that light was blocked with laser eye protection devices for carbon dioxide less than 380, holmium:YAG greater than 850, Nd:YAG less than 350 and greater than 950, and KTP less than 550 and greater than 750 nm. CONCLUSIONS: The laser eye protection device for KTP causes significant blue-yellow and red-green color confusion. Laser eye protection devices for carbon dioxide, holmium:YAG and Nd:YAG cause no significant color confusion compared to controls. The differences are explained by laser eye protection spectrophotometry characteristics and visual physiology.

Color vision deficits during laser lithotripsy using safety goggles for coumarin green or alexandrite but not with holmium:YAG laser safety goggles.

PURPOSE: Laser lithotripsy requires urologists to wear laser eye protection. Laser eye protection devices screen out specific light wavelengths and may distort color perception. This study tests whether urologists risk color confusion when wearing laser eye protection devices for laser lithotripsy. MATERIALS AND METHODS: Urologists were tested with the Farnsworth Dichotomous Test for Color Blindness (D-15) and the Farnsworth-Munsell 100-Hue Test (FM-100) without (control) and with laser eye protection devices for coumarin green, alexandrite and holmium:YAG lasers. Error scores were tabulated. The pattern of color deficits was characterized with confusion angles, confusion index (C-index), scatter index (S-index) and color axes. Laser eye protection devices were tested with spectrophotometry for spectral transmittance and optical density. RESULTS: The D-15 transposition errors (mean plus or minus standard deviation) for control, holmium:YAG, alexandrite and coumarin green laser eye protection were 0 +/- 0, 0 +/- 0, 0.3 +/- 0.5 and 6.4 +/- 1.6, respectively (p = 0.0000001). The FM-100 error scores (mean plus or minus standard deviation) were 20 +/- 15, 20 +/- 14, 91 +/- 32 and 319 +/- 69, respectively (p = 0.0001). The confusion index scores indicated a mild color confusion for the alexandrite and pronounced color confusion for the coumarin green laser eye protection. The confusion angles and scatter indexes mimicked a congenital blue-yellow deficit for coumarin green laser eye protection. Color axes showed no significant deficits for control or holmium:YAG laser eye protection in any subject, red-green axis deficits in 3 of 6 tested with alexandrite and blue-yellow axis deficits in 12 of 12 tested with coumarin green (p < 0.001). Spectrophotometry showed that laser eye protection for coumarin green blocks light less than 550 nm., alexandrite blocks light greater than 650 nm. and holmium:YAG blocks light greater than 825 nm. CONCLUSIONS: Laser eye protection for coumarin green causes pronounced blue-yellow color confusion, whereas alexandrite causes mild red-green color confusion among urologists, holmium:YAG causes no significant color confusion compared to controls. The differences are explained by laser eye protection spectrophotometry characteristics and visual physiology.