{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T18:16:32Z","timestamp":1772648192525,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Background: Transcatheter aortic valve implantation (TAVI) is increasingly performed in fluoroscopy-intensive environments, raising concerns about occupational eye lens dose (equivalent dose to the eye lens, Hp (3)) and the risk of radiation-induced cataract, particularly after the reduction of recommended annual eye lens dose limits to 20 mSv. Purpose: To summarize evidence on eye lens radiation exposure during TAVI, identify procedural and occupational determinants, and review strategies to reduce exposure with a focus on imaging optimization. Methods: We performed a narrative review of observational and prospective studies reporting direct eye-level dose measurements or validated surrogate eye lens dose estimates (head-level, chest-level, or DAP-normalized) during TAVI and related structural heart procedures. This approach was chosen to provide a qualitative synthesis of the available evidence rather than a formal systematic review. Results: Reported operator eye lens doses typically ranged from 30 to 110 \u00b5Sv per procedure, with higher exposure during transapical\/transaortal access and among staff working close to the patient (e.g., anesthesiologists and circulating nurses). Additional shielding and lead-free drapes reduced normalized eye dose by approximately 25\u201340%, and RADPAD\u00ae use reduced operator eye-level dose from 24.3 to 14.8 \u00b5Sv per procedure (p = 0.008). At these levels, cumulative exposure may approach recommended regulatory limits after approximately 150\u2013300 procedures, depending on role, access route, and shielding practices. Conclusion: In conclusion, Occupational eye lens exposure during TAVI is clinically relevant and strongly influenced by access route, staff positioning, and imaging-system use. Dose reduction should combine routine eye protection and dedicated eye-level dosimetry with imaging optimization (low pulse-rate fluoroscopy, minimized Digital-Subtraction-Angiography (DSA)\/cine acquisitions, tight collimation, avoidance of unnecessary magnification, and correct positioning of ceiling-suspended shields and table skirts).<\/jats:p>","DOI":"10.3390\/tomography12030036","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T15:01:07Z","timestamp":1772636467000},"page":"36","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Eye Lens Radiation Exposure During TAVI: Current Evidence and Imaging-Based Strategies for Dose Reduction"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7917-5027","authenticated-orcid":false,"given":"Chiara","family":"Zanon","sequence":"first","affiliation":[{"name":"Department of Radiology, University of Padua, Via Giustiniani 2, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Fiocco","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Tarzia","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2020-9365","authenticated-orcid":false,"given":"Emilio","family":"Quaia","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Padua, Via Giustiniani 2, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100328","DOI":"10.1016\/j.shj.2024.100328","article-title":"Addressing the Occupational Risk of Radiation Exposure in the Evolving Field of Interventional Echocardiography","volume":"8","author":"Lauten","year":"2024","journal-title":"Struct. 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