Canadian Urological Association Best Practice Report: Holmium:YAG Laser Eye Safety.

ObjectivesSince the introduction of the Holmium:yttrium-aluminum-garnet (Ho:YAG) laser over 2 decades ago, it has become an indispensable tool in the urologist's armamentarium.More specifically, in the subspecialty of endourology, the Ho:YAG laser has revolutionized the approach to kidney, ureteral and bladder stones, endoluminal tumours, strictures and benign prostatic hyperplasia (BPH) [1].Since its widespread adoption, and as with other laser wavelengths there have been concerns regarding its safety.In particular, the potential risks of eye injury to patients and operating room personnel have led laser manufacturers and governing bodies (including the Canadian Standards Association (CSA)) to require/mandate that all intraoperative personnel wear laser safety goggles.Despite this recommendation, the actual risk of eye damage associated with the Ho:YAG laser during endourological procedures has not been clearly defined.The objectives of this best practice report are to review the current literature regarding the risks of eye injuries and to provide practical and evidence-based recommendations on eye safety with the use of the Ho:YAG laser.This best practice report was developed in conjunction with members of the Canadian Endourology Group.