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Bajaj S, Orbuch D, Wang JV, Biesman BS, Geronemus RG. Interventional and device treatment of the periocular area. Clin Dermatol 2024; 42:360-372. [PMID: 38336142 DOI: 10.1016/j.clindermatol.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Growth in the research, innovation, and development of laser and energy-based technologies over the past few decades has led to dramatic increases in treatment options for dermatologic and cosmetic concerns of the periorbital area. We highlight recent treatment options using laser and energy-based devices for the clearance of periocular pigmented lesions, including solar lentigines and nevus of Ota; vascular lesions, including port-wine birthmarks, infantile hemangiomas, superficial telangiectasias, and reticular veins; laser ablation of benign tumors, such as xanthelasma; cosmetic rejuvenation; treatment of infraorbital dark circles and festoons; laser removal of eyebrow and eyeliner tattoos; and device-based treatment of chronic dry eyes.
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Affiliation(s)
- Shirin Bajaj
- Laser & Skin Surgery Center of New York, New York, New York, USA
| | - David Orbuch
- Laser & Skin Surgery Center of New York, New York, New York, USA
| | - Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, New York, USA.
| | - Brian S Biesman
- Nashville Centre for Laser and Facial Surgery, Nashville, Tennessee, USA
| | - Roy G Geronemus
- Laser & Skin Surgery Center of New York, New York, New York, USA
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2
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Meyer BI, Gutkind NE, Shoji MK, Rong AJ. Bilateral Thermal Keratopathy Due to Plasma Skin Regeneration. Ophthalmic Plast Reconstr Surg 2024; 40:e89-e91. [PMID: 38738721 DOI: 10.1097/iop.0000000000002618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
A 40-year-old woman underwent periocular plasma skin regeneration, a cosmetic treatment for periorbital rejuvenation. She subsequently developed bilateral thermal keratitis, manifesting as blurred vision, irritation, and redness, with a vision decrease to 20/60 and 20/50 in her OD and OS, respectively. Examination demonstrated bilateral large, irregular corneal epithelial defects and edema, necessitating treatment with amniotic membrane grafts, bandage contact lenses, and hypertonic saline. One year posttreatment, her visual acuity improved to 20/20 and 20/25, albeit with ongoing symptomatic dryness and bilateral anterior stromal haze. This case, as only the second reported instance of ocular damage from periocular plasma skin regeneration, underscores the need for heightened awareness of potential ocular complications following plasma skin regeneration and reinforces the importance of protective measures during periocular procedures.
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Affiliation(s)
- Benjamin I Meyer
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Naomi E Gutkind
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Marissa K Shoji
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
- Department of Oculofacial Plastic and Orbital Surgery, Shiley Eye Institute, University of San Diego California, San Diego, California, U.S.A
| | - Andrew J Rong
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
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3
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Bonińska K. Dermatologic laser-induced ocular and periocular complications: a review. BMC Ophthalmol 2023; 23:419. [PMID: 37858054 PMCID: PMC10588089 DOI: 10.1186/s12886-023-03159-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/28/2023] [Indexed: 10/21/2023] Open
Abstract
This study aimed to discuss severe ocular and periocular complications after dermatological laser treatment. This literature review evaluated published journal articles (clinical trials or scientific reviews) extracted from electronic databases (MEDLINE and PubMed) and the reference lists of related articles. Individual eyeball structures, such as chromophores, were found to interact with laser radiation. The type of damage was found to be influenced by the wavelength emitted by the laser-active medium. Moreover, in the absence of proper protection of the eyeballs, the structures that are crucial for vision can be damaged. In conclusion, laser treatment can also cause serious and irreversible complications. Appropriate patient selection, intraoperative techniques, early identification, and interventions for adverse postoperative effects are crucial to avoid major complications and even blindness.
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Affiliation(s)
- Karolina Bonińska
- Miejskie Centrum Medyczne Jonscher, ul. Milionowa 14, 93-113, Łódź, Poland.
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Alharbi MM, Bin Dlaim MS, Alqahtani JM, Alkhudhairy NS, Almasoudi SM, Alajmi NT. Ophthalmic Complications of Periorbital and Facial Aesthetic Procedures: A Literature Review. Cureus 2023; 15:e41246. [PMID: 37529817 PMCID: PMC10388289 DOI: 10.7759/cureus.41246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 08/03/2023] Open
Abstract
The emergence and popularity of cosmetic facial procedures may lead to significant ophthalmic complications such as ocular motility dysfunction and visual disability. Here, we present a scoping review to identify common ophthalmic complications in some facial plastic surgeries and cosmetic injections, and to develop clinical approaches for prophylaxis and management in terms of direct attention and awareness of non-ophthalmologists toward such scenarios and appropriate intervention. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following keywords were used to search PubMed, Scopus, Web of Science, and Google Scholar: "facial laser", "facial fillers", "facial injections", "hyaluronic acid", "local facial injections of botulinum toxin", "rhinoplasty", "blepharoplasty blindness", "ophthalmoplegia", "diplopia", "ptosis", "ophthalmic artery occlusion", "posterior ciliary artery occlusion", and "ocular ischemic syndrome". A total of 37 articles published between 1989 and 2021 were included, of which 21 were case reports. The most common ophthalmic complication was vision loss (0.0008%). The risk of ophthalmic complications including ocular pain, sudden unilateral or bilateral vision loss, flashes of light, ptosis, and ophthalmoplegia increase with injection in common anatomical regions like the glabella, nose, and supraorbital and nasolabial folds. The incidence of adverse events ranges from 5% to 18% in rhinoplasty. The most common complications after blepharoplasty were dry eye syndrome and diplopia, caused by eyelid ptosis. Eyelid, cornea, lens, and retina injuries are ophthalmic complications that occur after facial laser treatment. Ophthalmic complications after non-ophthalmic and cosmetic procedures are becoming increasingly common. The cumulative reported cases of ophthalmic complications after hyaluronic acid filler injection from 2016 to 2020 showed different types of adverse events, with the most common being decreased visual acuity, unilateral vision loss, and ptosis, with varying outcomes of each complication ranging from partial resolution to complete recovery. These complications must be recognized early, and prompt treatment must be established.
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Affiliation(s)
- Maryam M Alharbi
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Mohammed S Bin Dlaim
- Department of Ophthalmology, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Jawza M Alqahtani
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Najd S Alkhudhairy
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Shahad M Almasoudi
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Nouf T Alajmi
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
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5
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Wang JV, Bajaj S, Orbuch D, Lapidoth M, Klein I, Gerstein YA, Geronemus RG, Levi A. Safety and Efficacy of a Thermomechanical Fractional Injury Device for Periorbital Rhytides. Dermatol Surg 2023; 49:374-377. [PMID: 36826343 DOI: 10.1097/dss.0000000000003728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Periorbital rejuvenation is a common cosmetic concern. A fractional thermomechanical skin rejuvenation system was developed to offer clinical improvements from direct heat transfer. OBJECTIVE A prospective study evaluated the efficacy and safety of the device for periorbital fine lines and wrinkles. MATERIALS AND METHODS Subjects with moderate-to-severe periorbital rhytides were enrolled and underwent 4 monthly treatments with a novel device using thermomechanical fractional injury (Tixel 2; Novoxel, Netanya, Israel). RESULTS Fifty-one subjects were enrolled. Mean age was 56.8 years, and 88.2% were women. Fitzpatrick skin Types I to IV were included. For Fitzpatrick Wrinkle Classification System (FWCS), mean baseline score was 5.7. Per investigator, there was a mean 2.0-grade improvement in FWCS at 3-month follow-up ( p < .0001). Per 3 blinded physician raters, there was a mean improvement of 2.2 ( p < .0001), 2.0 ( p < .0001), and 1.2 ( p < .0001) in FWCS at 3-month follow-up. Each of the raters correctly identified posttreatment images for 87.5%, 77.1%, and 75.0% of subjects. At least 2 raters agreed on grading 83.3% of subjects as responders. There were no severe adverse events. Subjects experienced minimal pain and downtime. CONCLUSION A novel device using thermomechanical fractional injury was demonstrated to be safe and effective in the treatment of periorbital rhytides.
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Affiliation(s)
- Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, New York
| | - Shirin Bajaj
- Laser & Skin Surgery Center of New York, New York, New York
| | - David Orbuch
- Laser & Skin Surgery Center of New York, New York, New York
| | - Moshe Lapidoth
- Photodermatosis Service Laser Unit, Division of Dermatology, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Assi Levi
- Photodermatosis Service Laser Unit, Division of Dermatology, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Flegel L, Kherani F, Richer V. Review of Eye Injuries Associated With Dermatologic Laser Treatment. Dermatol Surg 2022; 48:545-550. [PMID: 35333214 DOI: 10.1097/dss.0000000000003427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The eye is susceptible to damage during dermatologic laser treatments. OBJECTIVE Discuss the anatomy of the eye related to these procedures, the principles of laser-eye interactions, and ocular injuries reported with dermatologic laser treatments. METHODS PubMed and Embase searches were conducted to identify cases of eye injuries associated with dermatologic laser treatments. RESULTS One hundred nineteen cases of eye injury associated with dermatologic laser treatments were identified. Fifty-nine cases targeted the eyelid during resurfacing and caused ectropion, while 60 cases resulted from direct injury of ocular structures. In most of the cases of the latter, improper eye protection was used (44 of 60, 73%). In nearly all these cases, it was the patient who sustained a potentially avoidable ocular injury (52 of 60, 87%). Thirty-one patients had persistent ocular symptoms at follow-up (52%). The most common procedure in this context was laser hair removal of the face (35 of 60, 58%). Most of the cases developed injuries specific for the particular laser based on its wavelength and affinity to target certain ocular chromophores (59 of 60, 98%). CONCLUSION Most of the dermatologic laser-associated eye injury cases have occurred in the context of laser resurfacing or laser hair removal and are potentially preventable.
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Affiliation(s)
- Lisa Flegel
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Femida Kherani
- Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
- Heights Laser, Burnaby, British Columbia, Canada
| | - Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
- Pacific Derm, Vancouver, British Columbia, Canada
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Anisimova N, Arbisser L, Tzamalis A, Petrovski BÉ, Shilova N, Petrovski G, Anisimov S, Malyugin B. Corectopia grading: A novel classification system. Semin Ophthalmol 2021; 37:105-110. [PMID: 34057013 DOI: 10.1080/08820538.2021.1926517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: To present and validate the novel grading system for objective classification of corectopia.Subjects and Methods: We evaluated 28 eyes of 28 patients with or without corectopia and validated the grading and classification system for corectopia according to three major criteria: (i) direction, (ii) extent, and (iii) alteration of mydriasis. Intraclass correlation coefficient (ICC) and inter-rater agreement between 7 inexperienced and 1 experienced ophthalmologist against a golden standard (GS) were calculated.Results: The ICC for the 7 inexperienced ophthalmologists regarding the grading of direction and centration of the pupil was 0.83 (95% confidence interval (CI), 0.74 to 0.90; p < .001) and 0.57 (95% CI, 0.43 to 0.72; p < .001), respectively. The inter-rater agreement was the same or almost the same in cases of pupil decentration between the inexperienced, experienced ophthalmologists and the GS (k = 0.82; 95% CI, 0.64-1.00; p < .001). In assessing the direction of pupil displacement, the inter-rater agreement was almost perfect between the inexperienced (k = 0.93; 95% CI, 0.84-1.00; p < .001) and experienced (k = 0.92; 95% CI: 0.82-1.02; p < .001) ophthalmologists and the GS.Conclusion: The first detailed clinical classification is proposed for objective corectopia grading particularly relevant in documenting and assessing progressive disease. It was confirmed to be acceptable for clinical use by inexperienced and experienced ophthalmologists alike.
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Affiliation(s)
- Natalia Anisimova
- Department of Eye Diseases, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.,Private Eye Center Vostok-Prozrenie, Moscow, Russia
| | - Lisa Arbisser
- Department of Ophthalmology, John A. Moran Eye Center University of Utah, Salt Lake City, Utah, USA
| | - Argyrios Tzamalis
- Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Beáta Éva Petrovski
- Center for Eye Research Department of Ophthalmology, Institute of Clinical MedicineFaculty of Medicine, University of Oslo, Oslo, Norway
| | - Natalya Shilova
- Department of Cataract and Implant Surgery, S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Goran Petrovski
- Center for Eye Research, Department of Ophthalmology, Oslo University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sergey Anisimov
- Department of Eye Diseases, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.,Private Eye Center Vostok-Prozrenie, Moscow, Russia
| | - Boris Malyugin
- Department of Eye Diseases, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.,Department of Cataract and Implant Surgery, S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
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8
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Ocular Complications After Laser or Light-Based Therapy-Dangers Dermatologists Should Know. Dermatol Surg 2021; 47:624-629. [PMID: 33731574 DOI: 10.1097/dss.0000000000002974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Laser and light-based technologies have been used in the medical field for over 50 years. In dermatologic and cosmetic practice, cutaneous side effects are commonly discussed; however, ocular injury may also occur. OBJECTIVE To complete a systematic review of the current literature regarding ocular complications in the dermatologic field after laser and/or light-based therapies. MATERIALS AND METHODS A systematic review of the Medline database was performed in August 2020 using the search terms "laser or light and ocular and complication." The inclusion criteria were articles written in English discussing ocular complications after laser or light-based therapy for dermatologic or cosmetic indications. RESULTS A total of 36 articles were included for review. Carbon dioxide was the most frequently used laser causing ocular damage, and the most common ophthalmologic complication was temporary ectropion. Patients described visual disturbances and pain as the most common symptoms. A large proportion of articles did not report the use of appropriate eye protection at the time of injury. CONCLUSION Although ocular injury post-laser or light-based procedures are rare, clinicians must be acutely aware of the signs and symptoms associated with eye damage. The informed consent process should thoroughly describe the possibility of ocular complications post-treatment, and medical practices should have appropriate emergency plans and protective equipment in place to decrease both patient and staff risk of injury.
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9
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Heitmiller K, Ring C, Saedi N, Biesman B. Nonsurgical Light and Energy-Based Devices: Utility in Eyelid and Periorbital Surgery. Facial Plast Surg Clin North Am 2021; 29:323-334. [PMID: 33906764 DOI: 10.1016/j.fsc.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Periorbital rejuvenation is a common reason for patients to seek cosmetic treatment. There are several nonsurgical light and energy-based devices available to treat various aspects of periorbital rejuvenation without risks of an invasive, surgical procedure. Although ablative laser resurfacing appears to offer the most impressive clinical improvements, nonablative devices result in noticeable cosmetic improvement with more favorable side-effect profiles and shorter recovery times. The specific modality selected for periorbital rejuvenation should be tailored to patients' individual characteristics, preferences, and aesthetic goals. With continued advancements, additional nonsurgical light and energy-based devices will become available in the future for periorbital rejuvenation.
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Affiliation(s)
- Kerry Heitmiller
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Christina Ring
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nazanin Saedi
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Brian Biesman
- Ophthalmology, Dermatology, Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA
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10
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Crowell EL, Jampel H, Berkenstock M. Alexandrite laser induced uveitis & pigment dispersion: A case report and review of the literature. Am J Ophthalmol Case Rep 2020; 18:100632. [PMID: 32181413 PMCID: PMC7063328 DOI: 10.1016/j.ajoc.2020.100632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 11/06/2022] Open
Abstract
Purpose To describe a complication of an upper eyelid alexandrite laser procedure. Observations A 55-year-old woman presented with left eye blurred vision and photophobia after a left upper eyelid procedure with an alexandrite laser. She had elevated intraocular pressure (IOP), anterior chamber cell and pigment, posterior synechiae, and retroillumination defects in the left eye. She was treated with topical prednisolone and brimonidine. Six months later, although her anterior chamber had cleared and IOP had normalized, the patient reported decreased vision-related quality of life from persistent photophobia. Conclusions and Importance Alexandrite lasers are commonly used for hair removal and skin depigmentation. When used periocularly without proper eye protection, they have the potential to create irreversible ocular complications. This case demonstrates the importance of proper eye protection with periocular laser procedures.
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Affiliation(s)
- Eric L Crowell
- Dell Medical School, 1601 Trinity St., Bldg. B, Z1200, Austin, TX, 78712, USA
| | - Henry Jampel
- Dell Medical School, 1601 Trinity St., Bldg. B, Z1200, Austin, TX, 78712, USA
| | - Meghan Berkenstock
- Dell Medical School, 1601 Trinity St., Bldg. B, Z1200, Austin, TX, 78712, USA
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11
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AlTaleb RM, Alsharif HM, Younis AS, Alsulaiman SM, Abouammoh MA. Adherence to optical safety guidelines for laser-assisted hair removal. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:313-317. [PMID: 31006142 DOI: 10.1111/phpp.12473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 03/23/2019] [Accepted: 04/14/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND In recent years, there was a rise in ocular injuries secondary to cosmetic laser-assisted hair removal. PURPOSE To assess the level of adherence to optical safety guidelines during laser-assisted hair removal performed by nurses or physicians in private practice. METHODS A cross-sectional study was conducted at thirty-one private laser-assisted hair removal clinics. An electronic random number generator using a cluster random sampling technique was used to select the clinics. The Alexlazr™ (Candela Corp.) device operator's manual checklist was modified to collect data from laser device operators and patients by surveying the laser rooms, interviewing the patients, and observing the treatments. RESULTS Ninety-four patients treated by different service providers were included from 31 private centers. All treatment sessions were delivered by trained nurses. Only 9.5% had acceptable adherence to optical safety guidelines during hair removal treatment, while the majority (90.5%) of service providers were poorly adherent. None of the providers achieved excellent adherence to optical safety guidelines. The item with the least adherence was the lack of non-reflective floors inside laser rooms in 72.3% of centers. All service providers were familiar with the laser system controls and emergency shutdown (100% adherence). CONCLUSION There is a significant deficiency in the safety precautions at laser-assisted hair removal centers that can result in devastating ophthalmic injuries. Companies providing laser-assisted hair removal machines should be involved in aiding these centers to implement safety procedures.
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Affiliation(s)
- Rawan M AlTaleb
- Department of Dermatology, King Saud Medical City, Riyadh, Saudi Arabia.,Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Heba M Alsharif
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Afnan S Younis
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Marwan A Abouammoh
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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12
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Affiliation(s)
- Siwei Zhou
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ian P Conner
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Evan L Waxman
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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13
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Asiri MS, Alharbi M, Alkadi T, Abouammoh M, Al-Amry M, ALZahrani Y, Alsulaiman SM. Ocular injuries secondary to alexandrite laser-assisted hair removal. Can J Ophthalmol 2017; 52:e71-e75. [PMID: 28457309 DOI: 10.1016/j.jcjo.2016.09.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/04/2016] [Accepted: 09/20/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to describe the clinical manifestations and outcomes of 4 patients who had sustained eye injury during alexandrite laser-assisted hair removal. METHODS This was a retrospective case series of 4 patients who presented to 2 tertiary eye care hospitals over 2 years. Data on ophthalmic examination, spectral domain optical coherence tomography (Heidelberg Engineering, Heidelberg, Germany), and fundus fluorescein angiography were collected. RESULTS Four female patients sustained injuries during alexandrite laser hair removal. One patient presented with acute anterior uveitis, 2 patients with subfoveal choroidal neovascularization, and 1 patient with intraretinal foveal hemorrhage. Visual acuity at last follow-up (range 3-6 months) was 20/15 to 20/20. CONCLUSIONS Ocular injuries can occur as a result of incorrect use of laser-assisted hair removal devices. Ophthalmologists should be aware of ocular damage caused by these devices.
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Affiliation(s)
| | | | - Trad Alkadi
- Imam Muhammad Ibn Saud University, Riyadh, Saudi Arabia
| | - Marwan Abouammoh
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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14
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Bulut MN, Çallı Ü, Göktaş E, Bulut K, Kandemir B, Özertürk Y. Use of an Intravitreal Dexamethasone Implant (Ozurdex) in a Case with Accidental Foveal Photocoagulation by Alexandrite Laser. Case Rep Ophthalmol 2016; 7:130-4. [PMID: 27293415 PMCID: PMC4899640 DOI: 10.1159/000444077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Alexandrite laser is one of the most common methods of hair removal. Its utilization is gradually increasing due to easy accessibility and high effectiveness. However, the disuse of protective goggles during the application of this laser is a serious problem. In this case report, we presented a 35-year-old male patient who had foveal injury by alexandrite laser. The inflammatory process secondary to the foveal injury and subsequent macular edema were treated with Ozurdex because of its potent antiedematous effect.
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Affiliation(s)
| | - Ümit Çallı
- Eye Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Eren Göktaş
- Eye Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Kezban Bulut
- Eye Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Baran Kandemir
- Eye Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Yusuf Özertürk
- Eye Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
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15
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Karabela Y, Eliaçık M. Anterior uveitis following eyebrow epilation with alexandrite laser. Int Med Case Rep J 2015; 8:177-9. [PMID: 26379448 PMCID: PMC4567169 DOI: 10.2147/imcrj.s89965] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ocular tissues are known to be sensitive to damage from exposure to laser emissions. This study reports the case of a female patient with acute unilateral anterior uveitis caused by alexandrite laser-assisted hair removal of the eyebrows. We report a 38-year-old female who presented with unilateral eye pain, redness, and photophobia after receiving alexandrite (755 nm) laser epilation of both eyebrows. Best corrected visual acuity was 20/20 in both eyes. Right eye examination was normal. Left eye examination showed conjunctival injection and 2+/3+ cells in the anterior chamber. Intraocular pressure and fundus examination were normal. Topical steroids and cycloplegic drops were prescribed for 3 weeks. At the end of the 3-week follow-up, best corrected visual acuity was 20/20, and intraocular pressure and fundus examination were normal in both eyes. The left eye was white, and the anterior chamber was clear. The patient continues to be monitored. In conclusion, without adequate protective eyewear, laser hair removal of the eyebrows with alexandrite laser can lead to ocular damage.
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Affiliation(s)
- Yunus Karabela
- Department of Ophthalmology, Esenler Hospital, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Eliaçık
- Department of Ophthalmology, Kadıköy Medipol Hospital, Istanbul Medipol University, Istanbul, Turkey
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16
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Abstract
PURPOSE Laser-assisted epilation of eyebrow hair has become a common practice, but a number of ocular complications can occur. We report the cases of 2 patients who had unilateral anterior uveitis after having undergone laser removal of eyebrow hair. METHODS This report describes 2 patients who experienced eye pain, photophobia, redness, and edema after undergoing alexandrite (755 nm) laser epilation of the eyebrow area while not wearing protective eyewear or a corneal shield. RESULTS Eye examinations revealed that both patients had conjunctival injection, endothelial keratic precipitates, and cells in the anterior chamber of one eye. They were treated with topical cyclopentolate and steroid eye drops. Within a week, their symptoms had disappeared, and anterior chamber reactions were not seen. At their 3-month follow-ups, their visual acuity was 20/20, and eye examination results were normal for both eyes of each patient. CONCLUSIONS Laser-assisted epilation of eyebrow hair can lead to unilateral anterior uveitis, and individuals must be informed about the risks involved in laser eyebrow epilation.
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Ricci LH, Navajas SV, Carneiro PR, Söderberg SA, Ferraz CA. Ocular adverse effects after facial cosmetic procedures: a review of case reports. J Cosmet Dermatol 2015; 14:145-51. [DOI: 10.1111/jocd.12141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Lucas H. Ricci
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
| | - Samia V. Navajas
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
| | - Paula R. Carneiro
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
| | - Stephanie A. Söderberg
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
| | - Caroline A. Ferraz
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
- Department Ophthalmology; School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
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18
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Accidental foveal photocoagulation secondary to alexandrite laser. Eur J Ophthalmol 2014; 24:808-10. [PMID: 24760604 DOI: 10.5301/ejo.5000474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE In recent years, we have seen an increase in the use of laser systems in the field of aesthetics (mainly depigmentation and hair removal). Alexandrite laser is the most widely used.Case report. METHODS Case report. RESULTS We describe a case of retinal injury (foveal photocoagulation) directly related to an alexandrite laser hair removal procedure. CONCLUSIONS Hair removal by laser systems is a fast and efficient method. The use of lasers without adequate protective measures or by unqualified personnel increases the risk of ocular adverse effects.
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Yalçındağ FN, Uzun A. Anterior uveitis associated with laser epilation of eyebrows. J Ophthalmic Inflamm Infect 2013; 3:45. [PMID: 23587197 PMCID: PMC3637527 DOI: 10.1186/1869-5760-3-45] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 03/21/2013] [Indexed: 11/20/2022] Open
Abstract
Background The objective of the study is to report a case of unilateral anterior uveitis after laser hair removal of the eyebrows with an alexandrite laser. Findings A 36-year-old female presented with painful red eye and photophobia in her left eye 2 days after receiving alexandrite (755 nm) laser epilation of both eyebrows. Visual acuity was 20/20 in both eyes. Right eye examination was normal. Left eye examination showed conjunctival injection, 2+ cells in the anterior chamber, and local posterior synechiae. Intraocular pressure and fundus examination were normal in both eyes. Topical steroids and cycloplegic drops were prescribed. Three days after the initiation of topical treatment, there was a reduction in anterior chamber cells to 1+, but posterior synechiae was enhanced. One week after, there were 0.5+ cells in the anterior chamber and no further enlargement of posterior synechiae. At the 2-month follow-up, uncorrected visual acuity remained 20/20 in both eyes. Slit-lamp biomicroscopy of the right eye was normal. Intraocular pressure and fundus examination were still normal in both eyes. Although anterior chamber of the left eye was clear, posterior synechiae persisted. We are still following the patient. Conclusion Laser hair removal of the eyebrows can lead to ocular damage and should be avoided.
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Affiliation(s)
- Fatime Nilüfer Yalçındağ
- Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Cad, Dikimevi, Ankara, 06100, Turkey.
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Biesman B. Commentary: Treatment of Venous Infraorbital Dark Circles Using a Long-Pulsed 1,064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser. Dermatol Surg 2012; 38:1283. [DOI: 10.1111/j.1524-4725.2012.02359.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Town G, Ash C, Dierickx C, Fritz K, Bjerring P, Haedersdal M. Guidelines on the safety of light-based home-use hair removal devices from the European Society for Laser Dermatology. J Eur Acad Dermatol Venereol 2012; 26:799-811. [PMID: 22211702 DOI: 10.1111/j.1468-3083.2011.04406.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the past 5 years since their US introduction, there has been a rapid proliferation of light-based hair removal devices intended for home-use. In the last 2 years in Europe, sales already run into many tens of thousands of units with well-known multi-national companies entering the market. These guidelines provide a definition of light-based home-use technology, to inform healthcare professionals about home-use light-based technology and encourage manufacturers wishing to sell in Europe to adopt 'best practice'. The review presents the current status on standards and regulation issues and considers home-use safety issues, encompassing human, device and electrical safety, given risks to the eyes and skin from optical radiation both to the consumer and persons in the vicinity. Proposed technical measurement methodology is considered with focus on recognized critical parameters for the safe use of light-based hair removal technology including recording the technical performance and safety claims of a range of home-use hair removal devices. The literature review emphasizes potential adverse incidents and safety aspects of treating cosmetic conditions, such as unwanted hair growth. Although some regulations exist, they differ from region to region and there is a specific need for international common principles and guidelines relating to the manufacture, marketing and use of intense pulsed light and laser devices, including manufacturing standards for home-use products intended, amongst others, for cosmetic hair removal and photo-rejuvenation procedures. In these guidelines, the European Society for Laser Dermatology (ESLD) provides a professional view of what 'best practice' may imply for manufacturers and consumers alike.
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Affiliation(s)
- G Town
- Faculty of Applied Design & Engineering, University of Wales, Swansea Metropolitan University, Swansea, UK.
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Thaysen-Petersen D, Bjerring P, Dierickx C, Nash J, Town G, Haedersdal M. A systematic review of light-based home-use devices for hair removal and considerations on human safety. J Eur Acad Dermatol Venereol 2011; 26:545-53. [DOI: 10.1111/j.1468-3083.2011.04353.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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