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Lee KWA, Chan LKW, Lee AWK, Lee CH, Wan J, Yi KH. Ocular Complication in Facial Aesthetic Laser and Light Treatments: A Comprehensive Review. Diagnostics (Basel) 2024; 14:2006. [PMID: 39335685 PMCID: PMC11431483 DOI: 10.3390/diagnostics14182006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/07/2024] [Accepted: 09/09/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The increasing popularity of laser- and light-based esthetic treatments for facial rejuvenation has raised concerns regarding ocular safety. Although these procedures are generally considered safe and effective, there is a growing body of evidence highlighting the potential for ocular complications. This review aims to systematically analyze the types and mechanisms of ocular injuries associated with such treatments, as well as to evaluate preventive measures and management strategies. METHODS A comprehensive literature search was conducted using databases including MEDLINE, PubMed and Ovid for relevant studies published on clinical trials, diagnosis and treatment. Some papers were further reviewed using a double-blinding approach, varying sample sizes, control usage, randomization usage and objective endpoint measurements. All studies were classified according to the Oxford Centre for evidence-based medicine evidence hierarchy. RESULT Our review identified several types of ocular complications associated with facial laser or light treatments, including but not limited to conjunctival burns, corneal damage, retinal phototoxicity, and transient vision disturbances. The incidence of these complications varies significantly depending on the type of laser or light source employed, treatment parameters, and the anatomical proximity of the eyes to the treatment area. Factors such as inadequate protective measures, patient movement during the procedure, and the operator's experience were found to contribute to the risk of ocular injury. Strategies such as the use of appropriate eye protection, careful patient positioning, and thorough pre-treatment assessments were highlighted as essential preventive measures. CONCLUSION Ocular complications, though rare, represent a significant risk in facial esthetic laser and light treatments. This review underscores the importance of awareness among practitioners regarding the potential ocular hazards and the implementation of robust safety protocols. Future research is needed to establish standardized guidelines to minimize risks and enhance patient safety in esthetic dermatological practices. Continued education and improved protective strategies will be essential in safeguarding ocular health as the field of esthetic treatments continues to evolve. This comprehensive review serves as an essential resource for practitioners, informing them of ocular risks, management options, and the need for vigilance to mitigate complications in clinical practice.
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Affiliation(s)
| | | | | | | | - Jovian Wan
- Asia Pacific Aesthetic Academy, Hong Kong
| | - Kyu-Ho Yi
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
- Maylin Clinic (Apgujeong), Seoul 06005, Republic of Korea
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Cao Q, Zhang N, Chong A, Zhan Q. Spatiotemporal hologram. Nat Commun 2024; 15:7821. [PMID: 39242573 PMCID: PMC11379954 DOI: 10.1038/s41467-024-52268-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 08/29/2024] [Indexed: 09/09/2024] Open
Abstract
Spatiotemporal structured light has opened up new avenues for optics and photonics. Current spatiotemporal manipulation of light mostly relies on phase-only devices such as liquid crystal spatial light modulators to generate spatiotemporal optical fields with unique photonic properties. However, simultaneous manipulation of both amplitude and phase of the complex field for the spatiotemporal light is still lacking, limiting the diversity and richness of achievable photonic properties. In this work, a simple and versatile spatiotemporal holographic method that can arbitrarily sculpt the spatiotemporal light is presented. The capabilities of this simple yet powerful method are demonstrated through the generation of fundamental and higher-order spatiotemporal Bessel wavepackets, spatiotemporal crystal-like and quasi-crystal-like structures, and spatiotemporal flat-top wavepackets. Fully customizable spatiotemporal wavepackets will find broader application in investigating the dynamics of spatiotemporal fields and interactions between ultrafast spatiotemporal pulses and matters, unveiling previously hidden light-matter interactions and unlocking breakthroughs in photonics and beyond.
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Affiliation(s)
- Qian Cao
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, 200093, Shanghai, China
- Zhangjiang Laboratory, Shanghai, China
- University of Shanghai for Science and Technology, Shanghai Key Laboratory of Modern Optical System, Shanghai, China
| | - Nianjia Zhang
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, 200093, Shanghai, China
| | - Andy Chong
- Department of Physics, Pusan National University, Busan, 46241, Republic of Korea
- Institute for Future Earth, Pusan National University, Busan, 46241, Republic of Korea
| | - Qiwen Zhan
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, 200093, Shanghai, China.
- Zhangjiang Laboratory, Shanghai, China.
- University of Shanghai for Science and Technology, Shanghai Key Laboratory of Modern Optical System, Shanghai, China.
- Westlake Institute for Optoelectronics, Fuyang, Hangzhou, 311421, China.
- International Institute for Sustainability with Knotted Chiral Meta Matter (WPI-SKCM2), Hiroshima University, Higashihiroshima, Hiroshima, 739-8526, Japan.
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Kassirer S, Zachary CB, Marini L, Adatto M, Landau M. Laser tattoo removal strategies: Part II: A review of the methods, techniques, and complications involved in tattoo removal. J Am Acad Dermatol 2024:S0190-9622(24)00970-8. [PMID: 38980249 DOI: 10.1016/j.jaad.2024.05.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 05/11/2024] [Accepted: 05/25/2024] [Indexed: 07/10/2024]
Abstract
The rising global popularity of cosmetic and corrective tattoos has concurrently led to an increased demand for their removal. While in the past, methods like surgical excision, chemical destruction, and dermabrasion were employed, lasers have emerged as a reliable and effective tool for tattoo removal. Increasing technological options and combination treatment strategies have raised the importance of understanding the various approaches to laser tattoo removal along with their respective clinical impact. This CME aims to describe the multifaceted aspects of laser tattoo removal, including the method selection, application principles, and safety considerations. Furthermore, it addresses the factors considered when selecting the most suitable laser to achieve optimal treatment outcomes.
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Affiliation(s)
- Samuel Kassirer
- American Medical Program, Tel Aviv University Faculty of Medicine, Tel Aviv, Israel
| | | | - Leonardo Marini
- Diplomate General Surgery and Dermatology, Medical and Scientific Director, SDC The Skin Doctors Center, Trieste, Italy
| | - Maurice Adatto
- Skinpulse Dermatology & Laser Centre, Geneva, Switzerland
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Yang S, Lei C, Zhang M. Vitrectomy for a traumatic macular hole caused by cosmetic laser in a beauty salon: A case report. Heliyon 2024; 10:e28466. [PMID: 38638955 PMCID: PMC11024555 DOI: 10.1016/j.heliyon.2024.e28466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Background The Nd:YAG laser is widely used in various aspects of work and life. Currently, it has become a popular cosmetic technique in beauty salons. The laser can be dangerous when it flashes into people's eyes. Case presentation A 34-year-old female sustained a 1064-nm Q-switched Nd:YAG laser injury to her left eye. One month after the injury, she presented to our clinic with best-corrected visual acuity (BCVA) of 20/250 and a full-thickness macular hole on the optical coherence tomography (OCT). The patient received pars plana vitrectomy, internal limiting membrane peeling and sterile air injection 3 months after the injury. OCT showed closure of the hole 9 days postoperatively. After a 3-month follow-up, her BCVA improved to 20/100. Conclusions This case report comprehensively introduces the whole progression of a cosmetic laser-induced macular hole from formation to recovery. Due to the potential threats of the laser and its irreversible damage to the retina and choroid, sufficient education should be given before performing any laser devices, especially those without professional knowledge.
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Affiliation(s)
- Songyue Yang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Chunyan Lei
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China
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5
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Ma Q, Fan Y, Cui Y, Luo Z, Kang H. A Preliminary Study on Quantitative Analysis of Collagen and Apoptosis Related Protein on 1064 nm Laser-Induced Skin Injury. BIOLOGY 2024; 13:217. [PMID: 38666829 PMCID: PMC11048553 DOI: 10.3390/biology13040217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024]
Abstract
To investigate the associated factors concerning collagen and the expression of apoptosis-related proteins in porcine skin injuries induced by laser exposure, live pig skin was irradiated at multiple spots one time, using a grid-array method with a 1064 nm laser at different power outputs. The healing process of the laser-treated areas, alterations in collagen structure, and changes in apoptosis were continuously observed and analyzed from 6 h to 28 days post-irradiation. On the 28th day following exposure, wound contraction and recovery were notably sluggish in the medium-high dose group, displaying more premature and delicate type III collagen within the newly regenerated tissues. The collagen density in these groups was roughly 37-58% of that in the normal group. Between days 14 and 28 after irradiation, there was a substantial rise in apoptotic cell count in the forming epidermis and granulation tissue of the medium-high dose group, in contrast to the normal group. Notably, the expression of proapoptotic proteins Bax, caspase-3, and caspase-9 surged significantly 14 days after irradiation in the medium-high dose group and persisted at elevated levels on the 28th day. During the later stage of wound healing, augmented apoptotic cell population and insufficient collagen generation in the newly generated skin tissue of the medium-high dose group were closely associated with delayed wound recovery.
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Affiliation(s)
- Qiong Ma
- Beijing Institute of Radiation Medicine, Beijing 100850, China; (Q.M.); (Y.C.)
| | - Yingwei Fan
- School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China;
| | - Yufang Cui
- Beijing Institute of Radiation Medicine, Beijing 100850, China; (Q.M.); (Y.C.)
| | - Zhenkun Luo
- Beijing Institute of Radiation Medicine, Beijing 100850, China; (Q.M.); (Y.C.)
| | - Hongxiang Kang
- Beijing Institute of Radiation Medicine, Beijing 100850, China; (Q.M.); (Y.C.)
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Keshet Y, Weseley PE, Ceisler EJ, Ngo WK, Salcedo A, Walia J, Spaide RF. THE EVOLUTION Of FULL-THICKNESS MACULAR HOLE AFTER SHORT EXPOSURE TO HIGH-POWERED HANDHELD LASER POINTER. Retin Cases Brief Rep 2024; 18:177-180. [PMID: 36730459 DOI: 10.1097/icb.0000000000001374] [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: 02/04/2023]
Abstract
PURPOSE To report a case of a full-thickness macular hole after exposure to an extremely powerful handheld laser pointer. METHODS A 14-year-old boy with a laser-induced full-thickness macular hole was evaluated 1 month after a momentary exposure to a 5,000 mW blue laser pointer. Imaging modalities including fundus color, autofluorescence, and spectral-domain optical coherence tomography, acquired both at our clinic and by the referring physician soon after the injury, are used to describe the clinical evolution of the case. RESULTS Soon after the injury, an intensely white, circular opacification of the retina approximately 400 μm in diameter was seen in the fovea. Early spectral-domain optical coherence tomography images showed full-thickness hyperreflectivity, likely representing tissue necrosis. One month later, a full-thickness macular hole and eradication of the retinal pigment epithelium at its base were evident in the fundus color, autofluorescence, and spectral-domain optical coherence tomography images. CONCLUSION High-power laser pointers have become easily available online. The presenting findings after exposure to such high-power devices are distinct from those reported after exposure to weaker laser pointers. Although long exposure to weaker lasers typically produces extensive, calligraphic figures and yellow placoid lesions involving only the outer retina, in our case, a very brief exposure led to focal full-thickness injury of the fovea.
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Affiliation(s)
- Yariv Keshet
- Vitreous Retina Macula Consultants of New York, New York; and New York University Langone, New York, New York
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7
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Banker AS, Mahadevia BM, Shah H, Banker AA. Full Thickness Macular Hole in Aesthetician Occurring Due to Accidental Self-exposure to Cosmetic Laser Machine Trying to Take Special Precautions Against COVID-19. J Cutan Aesthet Surg 2024; 17:75-77. [PMID: 38736866 PMCID: PMC11086931 DOI: 10.4103/jcas.jcas_74_21] [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] [Indexed: 05/14/2024] Open
Abstract
A 25-year-old aesthetician was operating Q-switch pulse (SPECTRA) cosmetic laser machine of 1,064 nm wavelength, for the purpose of skin bleaching. The probe suddenly slipped over the plastic sheet that had been placed to avoid COVID-19 exposure after which she complained of sudden loss of vision. She was diagnosed as having vitreous hemorrhage in her right eye and was treated conservatively for one month. She then complained of central scotoma and was diagnosed to have developed a full-thickness macular hole, for which she was advised vitrectomy surgery. The purpose of this case report is to emphasize the importance of taking precautions during the COVID-19 era and while doing that making sure how to handle the machines so as not to inflict any accidental injury to the operating physician. Macular Holes following skin bleaching with Nd:YAG laser occurring in operating aesthetician is rare as compared to that occurring in the patients.
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Affiliation(s)
- Alay S Banker
- Banker’s Retina Clinic and Laser Centre, Ahmedabad, Gujarat, India
| | | | - Harita Shah
- Banker’s Retina Clinic and Laser Centre, Ahmedabad, Gujarat, India
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8
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Shah RP, Dabre ZG, Sengupta S. An outbreak of subhyaloid hemorrhage after accidental laser exposure during an Indian festival. Indian J Ophthalmol 2024; 72:S144-S147. [PMID: 38131557 PMCID: PMC10833159 DOI: 10.4103/ijo.ijo_499_23] [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: 02/18/2023] [Revised: 07/01/2023] [Accepted: 07/27/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To report the clinical manifestations and outcomes of patients who experienced retinal damage due to accidental laser exposure during a festival in Kolhapur, Maharashtra. METHODS Consecutive patients who presented with sudden loss of vision following exposure to laser lights during a religious Indian festival (Ganapati festival) on the same day (9 September 2022) at the same location (idol visarjan procession) were identified from the medical records of various eye hospitals in Kolhapur district of Maharashtra. Eyes with persistent subhyaloid hemorrhage (SHH) were taken up for neodymium-doped yttrium aluminum garnet (Nd: YAG) posterior hyaloidotomy. Patients were examined at weekly intervals up to 1 month. RESULTS Thirty-four eyes of 34 men were identified with age ranging from 18 to 27 years. The mean duration of exposure to the laser projections was 4.9 ± 1.7 h, and the mean distance from the laser source was 7.3 ± 2.7 feet. All presented with SHH involving the macula. SHH had a median size of 3 disc diameters or larger in 30 eyes (88%), and 29 (97%) of these required hyaloidotomy while one patient underwent pars plana vitrectomy. The mean visual acuity improved from 1.45 ± 0.5 log of minimum angle of resolution (logMAR; 20/560 Snellen) to 0.11 ± 0.19 logMAR (20/25 Snellen) (P < 0.001). One eye showed full-thickness macular hole with visual acuity of 20/200. CONCLUSION We report a large number of patients experiencing laser-induced SHH, resembling an outbreak, due to exposure to a malfunctioning high-powered recreational laser during a religious festival.
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9
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Gopalakrishnan N, Nagesha CK, Gadde SGK, Jayadev C. Photic maculopathy after accidental exposure to a mirror-reflected non-therapeutic diode laser. BMJ Case Rep 2023; 16:e257345. [PMID: 38160033 PMCID: PMC10759013 DOI: 10.1136/bcr-2023-257345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
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10
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Ju M, Yoon K, Lee S, Kim KG. Single Quasi-Symmetrical LED with High Intensity and Wide Beam Width Using Diamond-Shaped Mirror Refraction Method for Surgical Fluorescence Microscope Applications. Diagnostics (Basel) 2023; 13:2763. [PMID: 37685301 PMCID: PMC10486995 DOI: 10.3390/diagnostics13172763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
To remove tumors with the same blood vessel color, observation is performed using a surgical microscope through fluorescent staining. Therefore, surgical microscopes use light emitting diode (LED) emission and excitation wavelengths to induce fluorescence emission wavelengths. LEDs used in hand-held type microscopes have a beam irradiation range of 10° and a weak power of less than 0.5 mW. Therefore, fluorescence emission is difficult. This study proposes to increase the beam width and power of LED by utilizing the quasi-symmetrical beam irradiation method. Commercial LED irradiates a beam 1/r2 distance away from the target (working distance). To obtain the fluorescence emission probability, set up four mirrors. The distance between the mirrors and the LED is 5.9 cm, and the distance between the mirrors and the target is 2.95 cm. The commercial LED reached power on target of 8.0 pW within the wavelength band of 405 nm. The power reaching the target is 0.60 mW in the wavelength band of 405 nm for the LED with the beam mirror attachment method using the quasi-symmetrical beam irradiation method. This result is expected to be sufficient for fluorescence emission. The light power of the mirror was increased by approximately four times.
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Affiliation(s)
- Minki Ju
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (M.J.); (K.Y.); (S.L.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
| | - Kicheol Yoon
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (M.J.); (K.Y.); (S.L.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
| | - Sangyun Lee
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (M.J.); (K.Y.); (S.L.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
| | - Kwang Gi Kim
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 beon-gil, Namdong-daero Namdong-gu, Incheon 21565, Republic of Korea; (M.J.); (K.Y.); (S.L.)
- Department of Biomedical Engineering, College of Health Science & Medicine, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences and Technology (GAIHST), Gachon University, 38-13, 3 Dokjom-ro, Namdong-gu, Incheon 21565, Republic of Korea
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Stein MJ, Aston SJ. Ancillary Procedures to Facelift Surgery: What has Changed? Aesthet Surg J Open Forum 2023; 5:ojad063. [PMID: 38828090 PMCID: PMC11140481 DOI: 10.1093/asjof/ojad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
The facelift remains the gold standard for rejuvenating the aging face. Many surgical techniques exist in the surgeon's armamentarium that vary based on scar burden, extent of skin undermining, and manipulation of the superficial musculoaponeurotic system. Yet, existing strategies predominantly address the mobile face and have limited effect on fixed zones such as perioral, periorbita, and forehead. Multiple ancillary techniques have therefore been developed to address this therapeutic gap in facial rejuvenation. The most popular techniques today include dermabrasion, lasers, chemical peels, and radiofrequency devices. All have demonstrable safety and efficacy and are chosen based on the patient's unique anatomical presentation, comfort level, and tolerability of recovery time. Surgeons are ideally equipped with the tools and skills to offer all modalities and then tailor their treatment to the specific patient's anatomy. Herein, we review the most effective ancillary procedures of the facelift and describe an evolution of their use in our practice. Level of Evidence 5
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Affiliation(s)
| | - Sherrell J Aston
- Corresponding Author: Dr Sherell J. Aston, 728 Park Avenue New York, NY 10021, USA. E-mail:
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12
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Mallat F, Chaaya C, Aoun M, Soutou B, Helou J. Adverse Events of Light-Assisted Hair Removal: An Updated Review. J Cutan Med Surg 2023; 27:375-387. [PMID: 37272371 DOI: 10.1177/12034754231174852] [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] [Indexed: 06/06/2023]
Abstract
BACKGROUND With light-assisted hair removal becoming widely used, reports of adverse effects are increasing. OBJECTIVE To review all the reported optical incidents and cutaneous complications of laser or intense pulse light-assisted hair removal. METHODS A PubMed database systematic search was performed to identify studies reporting such adverse events before July 2022 using the Mesh terms "adverse effects" AND "hair removal" AND ("laser" OR "intense pulse light"). RESULTS Altogether, 358 references were identified. After excluding duplicates, unrelated articles, guidelines, and conference abstracts, then adding references from studies bibliography, 104 publications were included. Ocular incidents consisted of anterior uveitis, iritis and iris atrophy, pupillary distortion, posterior synechiae, anterior chamber pigment, and cataracts in the anterior subcapsular region. Cutaneous complications consisted of pain, burns, folliculitis, leukotrichia, paradoxical hypertrichosis, pigmentary changes, changes in nevi, pili bigemini, herpes infection, hyperhidrosis, bromhidrosis, Fox-Fordyce disease, and frostbite from the cooling system. They were mostly correlated to skin type and body area as well as to light device and set parameters. Intense pulse light devices were found to be less painful than alexandrite laser, yet more painful than diode laser; Nd:YAG laser had the highest pain score. CONCLUSION Optical incidents can be systematically avoided. Cutaneous complications are usually related to professional errors and patient characteristics. Better knowledge of laser physics and adequate training of laser operators are key recommendations to avoid undesirable side effects. Safety recommendations help prevent most of the reported complications.
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Affiliation(s)
- Farid Mallat
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
| | - Céline Chaaya
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
| | - Maroun Aoun
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
| | - Boutros Soutou
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
- Dermatology Department, Hôtel-Dieu de France, Beirut, Lebanon
| | - Josiane Helou
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
- Dermatology Department, Hôtel-Dieu de France, Beirut, Lebanon
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Barone F, Amaral J, Bunea I, Farnoodian M, Gupta R, Gupta R, Baker D, Phillips MJ, Blanch RJ, Maminishkis A, Gamm DM, Bharti K. A versatile laser-induced porcine model of outer retinal and choroidal degeneration for preclinical testing. JCI Insight 2023; 8:157654. [PMID: 37288665 PMCID: PMC10393234 DOI: 10.1172/jci.insight.157654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
Over 30 million people worldwide suffer from untreatable vision loss and blindness associated with childhood-onset and age-related eye diseases caused by photoreceptor (PR), retinal pigment epithelium (RPE), and choriocapillaris (CC) degeneration. Recent work suggests that RPE-based cell therapy may slow down vision loss in late stages of age-related macular degeneration (AMD), a polygenic disease induced by RPE atrophy. However, accelerated development of effective cell therapies is hampered by the lack of large-animal models that allow testing safety and efficacy of clinical doses covering the human macula (20 mm2). We developed a versatile pig model to mimic different types and stages of retinal degeneration. Using an adjustable power micropulse laser, we generated varying degrees of RPE, PR, and CC damage and confirmed the damage by longitudinal analysis of clinically relevant outcomes, including analyses by adaptive optics and optical coherence tomography/angiography, along with automated image analysis. By imparting a tunable yet targeted damage to the porcine CC and visual streak - with a structure similar to the human macula - this model is optimal for testing cell and gene therapies for outer retinal diseases including AMD, retinitis pigmentosa, Stargardt, and choroideremia. The amenability of this model to clinically relevant imaging outcomes will facilitate faster translation to patients.
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Affiliation(s)
| | - Juan Amaral
- National Eye Institute (NEI), NIH, Bethesda, Maryland, USA
| | - Irina Bunea
- National Eye Institute (NEI), NIH, Bethesda, Maryland, USA
| | | | - Rohan Gupta
- National Eye Institute (NEI), NIH, Bethesda, Maryland, USA
| | - Rishabh Gupta
- National Eye Institute (NEI), NIH, Bethesda, Maryland, USA
| | - Dara Baker
- National Eye Institute (NEI), NIH, Bethesda, Maryland, USA
| | - M Joseph Phillips
- McPherson Eye Research Institute and Waisman Center, and
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Richard J Blanch
- Academic Department of Military Surgery and Trauma, Royal Centre for Defense Medicine, Birmingham, United Kingdom
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | | | - David M Gamm
- McPherson Eye Research Institute and Waisman Center, and
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Kapil Bharti
- National Eye Institute (NEI), NIH, Bethesda, Maryland, USA
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Wiest MRJ, Gunzinger JM, Hamann T, Fasler K, Said S, Bajka A, Muth DR, Barthelmes D, Blaser F, Zweifel SA. Natural Course of Solar and Laser-Associated Retinal and Macular Injuries at a Primary Care Hospital in Switzerland. Klin Monbl Augenheilkd 2023; 240:516-521. [PMID: 37164408 DOI: 10.1055/a-2021-7724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Solar and laser-associated retinopathies are rare occurrences. The two retinopathies are both photo-induced but differ in the involved intensity and duration of exposure. The purpose of this study was to evaluate the clinical features and natural course of these two entities, with a focus on the changes in the outer retina over time. PATIENTS AND METHODS This retrospective analysis assessed patients with solar or laser maculopathy seen at the Department of Ophthalmology of the University Hospital Zurich in Switzerland over the last 10 years. Visual acuity (VA; Snellen) and optical coherence tomography (OCT) findings were reviewed and analyzed at baseline and last follow-up visit. Areas of damaged outer retina, identified on en face OCT images as hyporeflective areas, were tagged and compared between visits. Descriptive analysis was performed by calculating mean values ± standard deviation (SD). Statistical evaluation was done using the Wilcoxon signed rank test. A p value < 0.05 was considered statistically significant. RESULTS Five patients with solar retinopathy and six patients with laser-associated retinopathy were identified. In the solar retinopathy group, mean VA at baseline was 0.80 (SD ± 0.37) and improved to 0.90 (SD ± 0.36). This was not statistically significant (p = 0.066). In the laser-associated retinopathy group, mean VA at baseline was 0.89 (SD ± 0.18) and improved to 1.03 (SD ± 0.09), which was not statistically significant either (p = 0.063). At baseline, in OCT cross-sections, initial changes were observed in the interdigitation, myoid, and ellipsoid zone, as well as the outer nuclear layer and the Henle fiber layer. At follow-up, most cases presented an alteration in the residual ellipsoid zone, with the degree of the aforementioned alterations depending on the size of the initial defect. A decrease of the hyporeflective alterations measured in en face OCT scans was observed in both groups but was only statistically significant in the laser-associated retinopathy group (p = 0.018 versus p = 0.172). CONCLUSIONS OCT can help to detect and monitor solar and laser-associated retinal injuries. Most injuries are minor, with good functional restitution. Minor changes in the ellipsoid zone often persist, even in cases with full visual recovery.
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Affiliation(s)
| | | | - Timothy Hamann
- Ophthalmology, University Hospital of Zurich, Zurich, Switzerland
| | - Katrin Fasler
- Ophthalmology, University Hospital of Zurich, Zurich, Switzerland
| | - Sadiq Said
- Ophthalmology, University Hospital of Zurich, Zurich, Switzerland
| | - Anahita Bajka
- Ophthalmology, University Hospital of Zurich, Zurich, Switzerland
| | | | | | - Frank Blaser
- Ophthalmology, University Hospital of Zurich, Zurich, Switzerland
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15
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Wang Y, La TT, Mason M, Tuten WS, Roorda A. Case Report: Multimodal, Longitudinal Assessment of Retinal Structure and Function following Laser Retinal Injury. Optom Vis Sci 2023; 100:281-288. [PMID: 36856552 PMCID: PMC10133204 DOI: 10.1097/opx.0000000000002004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
SIGNIFICANCE This case report demonstrates the use of novel imaging techniques and functional tests to longitudinally evaluate retinal structure and function after laser retinal injury. The structural and functional prognosis could be predicted with clinical findings, high-resolution retinal imaging, and functional testing. PURPOSE We present a laser retinal injury case in which an adaptive optics scanning laser ophthalmoscope and adaptive optics-based psychophysics were used to examine and monitor retinal structure and function after accidental exposure to a 1-W infrared laser beam. CASE REPORT A 23-year-old patient was unwittingly exposed to a 1-W, 852-nm continuous-wave laser at work as they noticed a small central blurry spot in the right eye. An initial eye examination was done 1 day after exposure, and the right eye's acuity was 20/25 -2 . Posterior segment evaluation revealed disrupted outer retina near the right eye's fovea. Adaptive optics imaging 2 weeks after the exposure revealed a 0.50 × 0.75° elliptical area with irregular borders and abnormal cone reflectivity just below the fovea. Starting at 1-month follow-up, structural recovery was observed on optical coherence tomography (OCT). Subsequent adaptive optics imaging showed significant recovery of cone reflectivity. Importantly, adaptive optics microperimetry showed measurable detection thresholds at all affected retinal locations at 6 months. By 10 months, all sites exhibited normal sensitivities. CONCLUSIONS Retinal structure and function from laser injury can be visualized and measured with OCT, adaptive optics imaging, and psychophysics. An intact Bruch's membrane on OCT and measurable retinal sensitivity by adaptive optics microperimetry may serve as good biomarkers for retinal recovery.
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Affiliation(s)
| | - Tammy T La
- Herbert Wertheim School of Optometry & Vision Science, University of California, Berkeley, Berkeley, California
| | - Melanie Mason
- Herbert Wertheim School of Optometry & Vision Science, University of California, Berkeley, Berkeley, California
| | - William S Tuten
- Herbert Wertheim School of Optometry & Vision Science, University of California, Berkeley, Berkeley, California
| | - Austin Roorda
- Herbert Wertheim School of Optometry & Vision Science, University of California, Berkeley, Berkeley, California
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16
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Williams LD, Zis P. COVID-19-Related Burning Eye Syndrome and Burning Mouth Syndrome: A Systematic Review and Meta-analysis. Pain Ther 2023; 12:621-630. [PMID: 36917411 PMCID: PMC10012304 DOI: 10.1007/s40122-023-00492-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Previous research highlights burning eye syndrome (BES) and burning mouth syndrome (BMS) as chronic complications of COVID-19 infection. The aim of this systematic review and meta-analysis is to establish the prevalence of COVID-19-related BES and COVID-19-related BMS and describe their phenomenology. METHODOLOGY A literature search in the PubMed database was performed, and seven papers (five on BES and two on BMS) were eligible to be included in this systematic review and meta-analysis. RESULTS The pooled prevalence of COVID-19-related BES was 9.9% (95% CI 3.4-25.4%). The frequency of COVID-19-related BMS is only reported in isolated cases and ranges from 4% in mild-to-moderate cases to 15% in severe, hospitalized cases, with female patients being mostly affected. COVID-19 severity is a potential risk factor for both BES and BMS. Neither syndrome occurs in isolation. COVID-19-related BES usually appears within the first week post-infection, persisting up to 9 weeks later. COVID-19-related BMS occurs during and after initial infection, and may also persist as a chronic disease. CONCLUSIONS Both BES and BMS are neuropathic COVID-19 infection complications, still under-studied and under-investigated, despite the fact that both are prevalent. Both COVID-19-related BES and COVID-19-related BMS could potentially be initial long COVID syndrome manifestations, and further research should be carried out in this field.
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Affiliation(s)
| | - Panagiotis Zis
- Medical School, University of Sheffield, Sheffield, UK. .,Medical School, University of Cyprus, Nicosia, Cyprus. .,Second Department of Neurology, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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17
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Coffey K, Abel L, Karas R, Gavrilescu M, Douglass A. Effect of laser eye protection devices on color perception. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2023; 40:A9-A15. [PMID: 37132997 DOI: 10.1364/josaa.477131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Laser eye protection (LEP) devices may alter how colors are perceived in visual displays. This study investigates changes in color perception experienced by color-normal observers while wearing LEPs. Color perception with and without LEPs was measured using clinical color tests: City University Color Assessment and Diagnosis, Konan Medical ColorDx CCT-HD, and Farnsworth-Munsell 100-Hue. All LEPs induced a shift in color perception. The level of change in color perception significantly varied across LEPs. Consideration should be made when designing color displays where LEP devices are worn.
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18
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Incidence and long-term outcome of laser pointer maculopathy in children. Int Ophthalmol 2023:10.1007/s10792-023-02638-w. [PMID: 36670265 DOI: 10.1007/s10792-023-02638-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE Single center study to evaluate the incidence and long-term outcome of laser pointer maculopathy (LPM). METHODS Medical records of 909,150 patients visiting our institution between 2007 and 2020 were screened in our electronic patient record system using the keywords "laserpointer," "laser pointer," and "solar." RESULTS Eight patients (6/2 male/female, 11 eyes) with a history of LPM were identified by fundoscopy and optical coherence tomography (OCT), all of whom were children (6/2 male/female). Mean age at injury was 12.1 years (range 6-16). Five children (62.5%) were injured between 2019 and 2020, three (37.5%) between 2007 and 2018. Median best-corrected visual acuity (BCVA) of affected eyes at first presentation was 20/25 (range 20/50-20/16). Follow-up examination was performed in seven children (10 eyes) with a median follow-up period of 18 months (range 0.5-96). BCVA improved in 4 children (5 eyes; BCVA at follow-up 20/22.5, range 20/40-20/16). Three of these four children were treated with oral steroids. OCT revealed acute signs such as intraretinal fluid to resolve quickly, while outer retinal disruption persisted until the last follow-up in eight of eleven eyes. These lesions resembled lesions of patients with solar retinopathy of which seven cases (11 eyes) were identified between 2007 and 2020. CONCLUSION Readily available consumer laser pointers can damage the retina and the underlying retinal pigment epithelium, possibly leading to long-lasting visual impairments. The number of laser pointer injuries has increased over the last years. Therefore, access to laser pointers for children should be strictly controlled.
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Reid G, Shirley K, Gamble R, George S, O'Gallagher M, Kearney J, McLoone E. Macular injuries secondary to handheld lasers in a paediatric population-clinical characteristics and indicators of visual impact. Eye (Lond) 2023; 37:176-182. [PMID: 35087213 PMCID: PMC9829854 DOI: 10.1038/s41433-021-01916-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 12/06/2021] [Accepted: 12/20/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND/OBJECTIVES Aim to identify incidence and prevalence of laser-induced retinal injuries in the Northern Ireland paediatric population and to determine negative clinical and OCT indicators in relation to visual acuity. SUBJECTS/METHODS A retrospective analysis was conducted of retinal injuries secondary to handheld laser pens over a 6-year time period with presenting and final visual acuity (VA), laser source and circumstances of the injury recorded. Fundus photographs and OCT images for each case were also collated. RESULTS Sixty-five patients (74 eyes) were identified of which 72% were male and mean age was 11.6 years. 40% of patients were symptomatic. Mean presenting VA was 0.16 LogMAR. VA was ≤0.30 LogMAR in 20 eyes (27%) at presentation. Features which impacted VA to a significant level were foveolar location, diffuse morphology, ELM and BM/RPE/IDZ disruption and ORH presence on presenting OCT images. ORHs or ELM disruption resulted in a significant risk ratio of 3.5 (p = 0.002) and 3.4 (p = <0.001) respectively. Mean presenting VA was demonstrated to improve during follow-up from 0.36 to 0.22 LogMAR (n = 20, p = 0.03). When VA was ≤0.30 LogMAR at presentation, mean presenting VA improved from 0.56 to 0.29 LogMAR (p < 0.01) with 58% of eyes improving to a VA of better than 0.30 LogMAR. CONCLUSIONS The overall visual loss from macular laser injuries was low and we have identified features on retinal imaging that significantly impact presenting VA. When VA is affected following macular laser injury there is evidence of recovery with >50% of those presenting with VA ≤ 0.30 LogMAR improving to better than 0.30 LogMAR.
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Affiliation(s)
- Gerard Reid
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK.
| | - Katherine Shirley
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
| | - Rachel Gamble
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
| | - Sonia George
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
| | - Michael O'Gallagher
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
| | - Jane Kearney
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
| | - Eibhlin McLoone
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
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20
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Kim JA, Park MJ, Song E, Roh E, Park SY, Lee DY, Kim J, Yu JH, Seo JA, Choi KM, Baik SH, Yoo HJ, Kim NH. Comparison of Laser and Conventional Lancing Devices for Blood Glucose Measurement Conformance and Patient Satisfaction in Diabetes Mellitus. Diabetes Metab J 2022; 46:936-940. [PMID: 35350088 PMCID: PMC9723205 DOI: 10.4093/dmj.2021.0293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/28/2022] [Indexed: 12/29/2022] Open
Abstract
Self-monitoring of capillary blood glucose is important for controlling diabetes. Recently, a laser lancing device (LMT-1000) that can collect capillary blood without skin puncture was developed. We enrolled 150 patients with type 1 or 2 diabetes mellitus. Blood sampling was performed on the same finger on each hand using the LMT-1000 or a conventional lancet. The primary outcome was correlation between glucose values using the LMT-1000 and that using a lancet. And we compared the pain and satisfaction of the procedures. The capillary blood sampling success rates with the LMT-1000 and lancet were 99.3% and 100%, respectively. There was a positive correlation (r=0.974, P<0.001) between mean blood glucose levels in the LMT-1000 (175.8±63.0 mg/dL) and conventional lancet samples (172.5±63.6 mg/dL). LMT-1000 reduced puncture pain by 75.0% and increased satisfaction by 80.0% compared to a lancet. We demonstrated considerable consistency in blood glucose measurements between samples from the LMT-1000 and a lancet, but improved satisfaction and clinically significant pain reduction were observed with the LMT-1000 compared to those with a lancet.
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Affiliation(s)
- Jung A Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Min Jeong Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Eyun Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - So Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Da Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jaeyoung Kim
- Research Institute for Skin Imaging, Korea University College of Medicine, Seoul, Korea
| | - Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Corresponding authors: Hye Jin Yoo Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea E-mail:
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Korea
- Nan Hee Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea E-mail:
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21
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Gil EM, Keppler M, Boretsky A, Yakovlev VV, Bixler JN. Segmentation of laser induced retinal lesions using deep learning (December 2021). Lasers Surg Med 2022; 54:1130-1142. [PMID: 35781887 PMCID: PMC9464686 DOI: 10.1002/lsm.23578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/18/2022] [Accepted: 06/13/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Detection of retinal laser lesions is necessary in both the evaluation of the extent of damage from high power laser sources, and in validating treatments involving the placement of laser lesions. However, such lesions are difficult to detect using Color Fundus cameras alone. Deep learning-based segmentation can remedy this, by highlighting potential lesions in the image. METHODS A unique database of images collected at the Air Force Research Laboratory over the past 30 years was used to train deep learning models for classifying images with lesions and for subsequent segmentation. We investigate whether transferring weights from models that learned classification would improve performance of the segmentation models. We use Pearson's correlation coefficient between the initial and final training phases to reveal how the networks are transferring features. RESULTS The segmentation models are able to effectively segment a broad range of lesions and imaging conditions. CONCLUSION Deep learning-based segmentation of lesions can effectively highlight laser lesions, making this a useful tool for aiding clinicians.
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Affiliation(s)
- Eddie M Gil
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
- SAIC, JBSA Fort Sam, Houston, Texas, USA
| | - Mark Keppler
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
- SAIC, JBSA Fort Sam, Houston, Texas, USA
| | | | - Vladislav V Yakovlev
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Joel N Bixler
- Air Force Research Laboratory, JBSA Fort Sam, Houston, Texas, USA
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22
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Coenzyme Q10 in the eye isomerizes by sunlight irradiation. Sci Rep 2022; 12:12104. [PMID: 35840805 PMCID: PMC9287378 DOI: 10.1038/s41598-022-16343-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/08/2022] [Indexed: 11/14/2022] Open
Abstract
Photoisomerization of lipids has been well studied. As for the eyes, photoisomerization from 11-cis isomer to all-trans-retinal is well-known as the first step of the visual transduction in the photoreceptors. In addition to that, there would be other ocular lipids that undergo photoisomerization, which may be involved in ocular health and function. To explore any photoisomerizable lipids in the eyes, the nonirradiated and sunlight-irradiated eyeball extracts were subjected to liquid chromatography-mass spectrometry analysis, followed by the identification of the decreased lipid species in the irradiated extracts. Surprisingly, more than nine hundred lipid species were decreased in the irradiated extracts. Three lipid species, coenzyme Q10 (CoQ10), triglyceride(58:4), and coenzyme Q9, were decreased both significantly (p < 0.05) and by more than two-fold, where CoQ10 showed the most significant decrease. Later, photoisomerization was identified as the prominent cause underlying the decrease of CoQ10. Interestingly, CoQ10 in the sunlight-irradiated fresh eyeballs was also isomerized. Both the visible light and ultraviolet radiation were capable of producing CoQ10 isomer, while the latter showed rapid action. This study is believed to enhance our understanding of the biochemistry and photodamage of the eye and can potentially contribute to the advancement of opto-lipidomics.
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23
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Kuwayama S, Kato A, Kuwayama S, Fujii S, Sugitani K, Osada A, Ogura Y, Yasukawa T. A case of Nd:YAG laser-induced traumatic macular hole with good visual prognosis after vitrectomy with inverted internal limiting membrane technique. Am J Ophthalmol Case Rep 2022; 25:101391. [PMID: 35198815 PMCID: PMC8841575 DOI: 10.1016/j.ajoc.2022.101391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To report an accidental case of traumatic macular hole caused by Nd:YAG laser in a dermatology clinic. Observations A 24-year-old woman sustained a laser injury to her right eye while practicing a dermatologic treatment using a Nd:YAG laser without wearing protective goggles. She noticed sudden-onset and progressing visual loss in her right eye and consulted an ophthalmologist 2 days after injury. The best-corrected visual acuity (BCVA) of her right eye decreased to 20/133. Fundus examination showed white parafoveal flecks with a central retinal hemorrhage and underlying serous retinal detachment. The retinal sensitivity in this lesion deteriorated. Two weeks later, a full-thickness macular hole (FTMH) developed in the affected eye. She was referred to Nagoya City University Hospital where the laser damage described was observed. The BCVA was 20/67. She underwent pars plana vitrectomy performed using the inverted internal limiting membrane (ILM) flap technique and gas tamponade. One week postoperatively, the FTMH closed, the BCVA in her right eye improved to 20/50, and the retinal sensitivity in the macular area mostly improved. The BCVA gradually improved and reached 20/25 9 months after the injury. Conclusions and importance Protective goggles must be worn when using an Nd:YAG laser in the laboratory or clinical setting. In the unfortunate event of a FTMH, early vitrectomy with an inverted ILM flap technique can be helpful to achieve a good visual prognosis.
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Affiliation(s)
- Satoshi Kuwayama
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Aki Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
- Corresponding author. Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Soichiro Kuwayama
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Syunsuke Fujii
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Kazuhiko Sugitani
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | | | - Yuichiro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Abstract
PURPOSE To describe the first case of macular hole formation following intense pulsed light therapy. METHODS This is a retrospective case report. A 68-year-old woman presented with blurry vision that occurred 1 day following intense pulsed light therapy for hair removal. RESULTS A full thickness macular hole, which had not been previously documented was noted on fundus exam. Ocular coherence tomography confirmed a full-thickness macular hole. DISCUSSION Laser treatment for hair removal has been reported to cause ocular injuries including iris atrophy, pupillary distortion, cataracts, and uveitis. Intense pulsed light therapy, a specific type of laser therapy, has been reported to cause iris transillumination defects, anterior uveitis, and pupil abnormalities. Our case is the first to describe a macular hole secondary to intense pulsed light therapy. The etiology of the macular hole is postulated to be secondary to possible thermal injury with absorption of energy at the level of the retinal pigment epithelium. This emphasizes the role and importance of preventative measures, such as protective glasses in reducing the risk of ocular injuries.
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Affiliation(s)
- Nenita Maganti
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL
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25
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Liu Z, Chauhan A. Gold nanoparticles-loaded contact lenses for laser protection and Meibomian Gland Dysfunction (MGD) dry eye treatment. Colloids Surf A Physicochem Eng Asp 2022. [DOI: 10.1016/j.colsurfa.2021.128053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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26
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Jiang F, Shi Y, Wang Z, Yang X. Case series of photic maculopathy associated with exposure to a plasma flash induced by a femtosecond laser. Lasers Surg Med 2022; 54:631-638. [PMID: 35043420 DOI: 10.1002/lsm.23519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/02/2022] [Accepted: 01/03/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Photic maculopathy resulting from laser-induced plasma flash has been rarely reported, and the corresponding mechanism of the injury is still unclear. We present a case series of three patients with bilateral macular injuries produced by exposure to the plasma radiation from femtosecond laser tightly focusing. STUDY DESIGN/MATERIALS AND METHODS Funduscopic findings were accompanied mainly by optical coherence tomography (OCT) investigation of the macula during the follow-up period. RESULTS All patients shared similar clinical symptoms soon after the initial injury, including reduced visual acuity and central scotomas. It was acutely characterized by foveolar yellowish faceted lesions upon fundus examination. The main OCT finding in the acute stage was a hyper-reflective area involving all foveolar retinal layers without retinal edema. Repeat OCT evaluation during the latter stages revealed that the retinal changes were reversible, but delineated mild pathology at the outer foveal retina. This retinal structural recovery was accompanied by improvements in visual acuity and central scotomas as well. CONCLUSIONS Prolonged viewing of a plasma flash induced by a focused femtosecond laser without eye protection may produce persistent damage to the retina. We believe that a photochemical process similar to the mechanism of a solar burn or welder's maculopathy may cause retinal damage in this case series.
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Affiliation(s)
- Fagang Jiang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Shi
- Department of Neonatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi Wang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaobo Yang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Walker BJ, Ma Y, Bormett I, Zarecki T, Swader RA, Callahan K, Steiner LJ, Eliceiri KW. Open Source Remote Monitoring of Research Lasers. OPTICS AND LASER TECHNOLOGY 2021; 143:107363. [PMID: 34262227 PMCID: PMC8274588 DOI: 10.1016/j.optlastec.2021.107363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
An open source remote monitoring system is designed and built to address the needs of researchers to provide basic illuminated visual indication of laser operation for university research laboratories that are equipped with multiple types of high-powered lasers and have limited financial resources. The 3D printed remote monitoring system selectively monitors either the total current running through a laser or a TTL shutter signal to wirelessly indicate at the laboratory entrances that a laser is in use. Several lasers can be monitored in a single room and each room entrance can have its own wireless laser activity indicator. The wireless feature eliminates the expense of in-wall wiring for the system. An emergency shut off switch is included as an optional attachment. This article describes the design of the readily deployed open source laser monitoring system, including how it was built and tested for integration into a microscopy research laboratory.
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Affiliation(s)
- Brandon J. Walker
- Morgridge Institute for Research, 330 N. Orchard St., Madison, WI 53715 USA
| | - Yiqun Ma
- Morgridge Institute for Research, 330 N. Orchard St., Madison, WI 53715 USA
- Department of Biomedical Engineering, University of Wisconsin, 1550 Engineering Drive., Madison, WI, 53706 USA
| | - Ian Bormett
- Morgridge Institute for Research, 330 N. Orchard St., Madison, WI 53715 USA
| | - Trevor Zarecki
- Morgridge Institute for Research, 330 N. Orchard St., Madison, WI 53715 USA
- Department of Biomedical Engineering, University of Wisconsin, 1550 Engineering Drive., Madison, WI, 53706 USA
| | - Robert A. Swader
- Morgridge Institute for Research, 330 N. Orchard St., Madison, WI 53715 USA
| | - Kylie Callahan
- Morgridge Institute for Research, 330 N. Orchard St., Madison, WI 53715 USA
| | - Leo J. Steiner
- Morgridge Institute for Research, 330 N. Orchard St., Madison, WI 53715 USA
- Department of Biomedical Engineering, University of Wisconsin, 1550 Engineering Drive., Madison, WI, 53706 USA
| | - Kevin W. Eliceiri
- Morgridge Institute for Research, 330 N. Orchard St., Madison, WI 53715 USA
- Department of Biomedical Engineering, University of Wisconsin, 1550 Engineering Drive., Madison, WI, 53706 USA
- Department of Medical Physics, University of Wisconsin, 1111 Highland Avenue, Madison, WI 53705 USA
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Marinescu AI, Hall CM. Laser-Induced Maculopathy and Outcomes After Treatment With Corticosteroids and Lutein. Cureus 2021; 13:e18470. [PMID: 34692258 PMCID: PMC8526046 DOI: 10.7759/cureus.18470] [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] [Accepted: 10/04/2021] [Indexed: 11/05/2022] Open
Abstract
This case report presents treatment outcomes for a patient with accidental laser-induced retinal injury. A 30-year-old man was evaluated for a sudden decrease of vision and metamorphopsia in his left eye after staring at a laser in a nightclub five days before presentation. Eye examination showed left visual acuity of 6/18-2 unaided, which improved to 6/12-2 on the pinhole test. Dilated fundoscopy showed a yellow-orange foveolar lesion in the left eye. Optic coherence tomography (OCT) showed an alteration of foveal anatomy predominantly involving the outer retinal layers, hyper-reflective vertical bands, and large cystoid change at the inner retina. Foveolar thickness was increased to 397 µ. Treatment was initiated with oral corticosteroids (prednisolone 0.5 mg/kg/day). At the one-week follow-up, left visual acuity improved to 6/12+2. Hardly any cystic changes were noted, with fewer hyper-reflective bands and less disruption at the outer layer. Treatment with prednisolone was continued and lutein capsules (20 mg/day) were added. At three weeks, the patient reported a return to normal vision, with left visual acuity of 6/6-2 unaided. On OCT, near-complete restoration of the macular structure was visualized. Although these results show positive clinical outcomes with combined oral corticosteroids and lutein over a short time for a typical case of laser-induced maculopathy, further review is recommended to determine the ideal treatment regimen.
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Taylor AW, Hsu S, Ng TF. The Role of Retinal Pigment Epithelial Cells in Regulation of Macrophages/Microglial Cells in Retinal Immunobiology. Front Immunol 2021; 12:724601. [PMID: 34484232 PMCID: PMC8414138 DOI: 10.3389/fimmu.2021.724601] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 07/28/2021] [Indexed: 12/28/2022] Open
Abstract
The ocular tissue microenvironment is immune privileged and uses several mechanisms of immunosuppression to prevent the induction of inflammation. Besides being a blood-barrier and source of photoreceptor nutrients, the retinal pigment epithelial cells (RPE) regulate the activity of immune cells within the retina. These mechanisms involve the expression of immunomodulating molecules that make macrophages and microglial cells suppress inflammation and promote immune tolerance. The RPE have an important role in ocular immune privilege to regulate the behavior of immune cells within the retina. Reviewed is the current understanding of how RPE mediate this regulation and the changes seen under pathological conditions.
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Affiliation(s)
- Andrew W Taylor
- Department of Ophthalmology, Boston University School of Medicine, Boston, MA, United States
| | - Samuel Hsu
- Department of Ophthalmology, Boston University School of Medicine, Boston, MA, United States
| | - Tat Fong Ng
- Department of Ophthalmology, Boston University School of Medicine, Boston, MA, United States
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30
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Macular hemorrhage after laser exposure and cannabinoid intake during a disco party. Am J Ophthalmol Case Rep 2021; 23:101129. [PMID: 34141953 PMCID: PMC8187161 DOI: 10.1016/j.ajoc.2021.101129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/28/2021] [Accepted: 05/24/2021] [Indexed: 12/28/2022] Open
Abstract
Purpose To describe two cases of macular hemorrhage in young patients, both occurred after laser exposure and cannabinoid intake during a disco party. Observations Case 1: a 21-year-old man was evaluated at our Emergency Unit for sudden vision loss in the right eye (RE). Best-corrected visual acuity (BCVA) was count fingers in the RE and 20/20 in the left eye (LE). Fundus examination revealed a broad pre-retinal hemorrhage in macular region of RE, confirmed by optical coherence tomography. The patient reported vision loss, suddenly occurred after fixation of a laser source and cannabinoid intake during a disco party the night before. We administered a macular supplement and closely followed up the patient. After two months BCVA of the right eye was 20/20. Case 2 The following day another 21-year-old man was referred to our Emergency Unit complaining of sudden vision loss in LE. As in Case 1, he reported to have fixed a laser beam as well as the consumption of cannabinoids at the same disco. BCVA was count fingers in the LE and 20/20 in the RE. Fundus examination showed a broad pre-retinal hemorrhage in macular region of LE. He had taken the macular supplement for two months and then the hemorrhage was reabsorbed. Conclusion and importance Laser exposure must be considered as a possible cause of macular hemorrhage. Furthermore, low cost of drugs and lack of formal control of laser sources may increase the emergence of new cases of retinal injuries especially among young people.
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Li C, Li J, Chen X, Lu P. Laser-induced choroidal neovascularization: A case report and some reflection on animal models for age-related macular degeneration. Medicine (Baltimore) 2021; 100:e26239. [PMID: 34115011 PMCID: PMC8202587 DOI: 10.1097/md.0000000000026239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/19/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Laser induced maculopathy includes retinal photoreceptor disruption, macular hole, macular hemorrhage, and rarely choroidal neovascularization (CNV). Here we report a case of laser induced CNV that was treated by intravitreal anti-vascular endothelial growth factor (VEGF) injection and resulted in visual improvement and CNV resolution during 1-year follow up. In addition, the case of laser induced CNV treated with intravitreal anti-VEGF injections are reviewed for the first time in literature. PATIENT CONCERNS A 7-year-old boy presented to our department with blurred vision in his right eye for 2 months. The symptom immediately happened after the boy staring at the laser beam for a few seconds. Examination of ocular fundus with slit lamp showed yellowish lesion in macula in his right eye. DIAGNOSES CNV was confirmed by fundus examinations, including color fundus photograph, spectral domain optical coherence tomography, fluorescein angiography, and spectral domain optical coherence tomography angiography. INTERVENTIONS After the diagnosis of laser induced CNV, intravitreal ranibizumab (LUCENTIS, NOVARTIS) injection was performed. OUTCOMES After 1 injection of intravitreal ranibizumab, the best corrected visual acuity improved from 20/50 to 30/50 and CNV gradually regressed during 1-year follow up. LESSONS For young patients with laser induced CNV, intravitreal anti-VEGF injections may be helpful in visual improvement and CNV regression. Moreover, age seems to be a significant factor thus we propose that old animals may be more appropriate for laser induced CNV animal models of age-related macular degeneration.
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Affiliation(s)
- Caixin Li
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University
| | - Jianqing Li
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University
| | - Xinzhu Chen
- Department of Ophthalmology, Suzhou EENT Hospital, Suzhou, Jiangsu Province, China
| | - Peirong Lu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University
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32
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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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Wang X, Zhang T, Jiang R, Xu G. Vitrectomy for laser-induced full-thickness macular hole. BMC Ophthalmol 2021; 21:135. [PMID: 33714272 PMCID: PMC7956069 DOI: 10.1186/s12886-021-01893-8] [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: 10/26/2020] [Accepted: 03/01/2021] [Indexed: 12/28/2022] Open
Abstract
Background To report the structure and visual outcomes of pars plana vitrectomy (PPV) for laser-induced full-thickness macular holes (MHs). Methods This retrospective study enrolled 10 patients who underwent vitrectomy for MHs caused by laser injury. Best corrected visual acuity (BCVA), macular spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA) were used for assessment. Results Four patients were injured by unexpected expose of an yttrium aluminum garnet (YAG) laser, and six patients were accidentally injured by a handheld laser. The MH minimum diameters (MDs) ranged from 55 to 966 μm (mean = 548.00 ± 286.10 μm), and BCVA ranged from 20/400 to 20/50 (mean = logMAR 0.87 ± 0.29) preoperatively. All 10 eyes underwent PPV, internal limiting membrane (ILM) peeling, and gas tamponade. All eyes demonstrated closure of the MH with different degrees of discontinuity of the outer layer of the retina, and four eyes exhibited serious retinal pigment epithelium (RPE) destruction. Postoperative BCVA values were significantly improved (mean = logMAR 0.55 ± 0.33; P = 0.032, t = 2.234). The mean BCVA of the destroyed RPE group was significantly worse than that of the non-destroyed RPE group both before and after surgery (P = 0.019; Wilcoxon signed rank test). Further, OCTA indicated choroidal ischemia in the laser-induced MHs. Conclusion Vitrectomy can be successful in closing laser-induced full-thickness MHs and improving visual acuity. However, If RPE/choroid is involved in laser damage in addition to the outer retinal layer, this may indicate poor visual prognosis.
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Affiliation(s)
- Xin Wang
- Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Ting Zhang
- Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Rui Jiang
- Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
| | - Gezhi Xu
- Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
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Siddiqui MZ, Ellabban AA, Soliman MK, Gini G, Kurup S, Uwaydat SH, Sallam AB. Survey of the use of laser protective eyewear among international retina specialists: a European vitreoretinal society study. BMJ Open Ophthalmol 2021; 6:e000647. [PMID: 33754128 PMCID: PMC7938992 DOI: 10.1136/bmjophth-2020-000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/13/2021] [Accepted: 01/30/2021] [Indexed: 11/22/2022] Open
Abstract
Objective To report the trends for the use of eye protection methods during retinal laser in clinic and operating room. Methods and analysis Retrospective analysis of a 14-item survey questionnaire submitted to the European Vitreoretinal Society members. Results Responses from 630 members were analysed. Most of the respondents practised in Europe (52.7%), followed by North America (21.0%). The majority of respondents had laser filters in the microscope for the operating surgeon (92.1%), or used protective goggles (6.8%). Only 38.9% of respondents indicated that auxiliary staff in the operative room used protective goggles during laser treatment. Three-dimensional retina viewing system was used by only 22.5% of respondents, of those, 34.5% reported use of laser protection goggles by the operating surgeon. Rates of laser protection by auxiliary staff were 62.9% for indirect laser and 60.8% for slit lamp laser. We found a higher rate for use of laser protection by auxiliary staff in North America-based practices for endolaser (p<0.00001), laser indirect ophthalmoscope (p<0.00001) and slit lamp laser (p=0.00033) compared with the rest of the world. Conclusion The use of laser protection methods is routinely adopted by the physicians in the operating room and clinic, but less so by their assisting or auxiliary staff.
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Affiliation(s)
- Mohammad Z Siddiqui
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arknasas, USA
| | - Abdallah A Ellabban
- Department of Ophthalmology, Suez Canal University, Ismailia, Egypt.,Department of Ophthalmology, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
| | - Mohamed K Soliman
- Ophthalmology, University of Ottawa Eye Institute, Ottawa, Ontario, Canada.,Ophthalmology, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Giampaolo Gini
- Ophthalmology, Western Sussex NHS University Trust, Chichester, UK
| | - Shree Kurup
- Department of Ophthalmology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arknasas, USA
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arknasas, USA
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35
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Gauldin D, Ahmad KT, Ferguson S, Uwaydat SH. Exposure of Contralateral Eyes to Laser Radiation during Retinal Photocoagulation. Curr Eye Res 2021; 46:1424-1427. [PMID: 33615938 DOI: 10.1080/02713683.2021.1884729] [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: 10/22/2022]
Abstract
Purpose/Aim: To investigate the risk of laser damage to the unprotected fellow eye of patients undergoing laser retinal photocoagulation with 532 nm diode pumped solid-state laser.Materials and Methods: A mannequin head was fitted with a Vega laser energy meter and PD10 photodiode laser measurement sensor. Lowest measurable energy for this sensor is 2 nJ at 900 nm. Simulated retinal laser treatments were performed on a model eye placed in one of the sockets of the mannequin head, while the laser sensor was placed in the opposite socket. Four simulated sessions of retinal photocoagulation were performed utilizing both slit lamp and indirect laser delivery systems. Each consisted of 10 applications of the laser directly into the model eye and 10 applications near but not directly into the sensor, utilizing various treatment settings.Results: No laser exposure was detected in the model eye during simulated retinal photocoagulation sessions aimed directly into the treatment eye. When the laser application was aimed near the sensor, no laser exposure was detected at the standard setting, however, in all sessions conducted at the higher laser power setting, the mean exposure detected was <6 µJConclusions: Laser exposure in the unprotected contralateral eye of patients undergoing retinal laser treatment with the PASCAL laser machine under standard PRP settings was found to be miniscule. However, we still recommend laser safety eyewear for the untreated eye to provide protection in the event of direct accidental laser exposure from surgeon error or laser malfunction, in accordance with the most current laser safety guidelines.
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Affiliation(s)
- Donald Gauldin
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kinza T Ahmad
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Scott Ferguson
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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36
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Srinivasan M, Ganesh S, Rao S. Scars of an old story: Laser pointer injury. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2021. [DOI: 10.4103/tjosr.tjosr_25_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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37
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Hayashi I, Mizobuchi K, Watanabe A, Nakano T. Mild accidental macular injury induced by picosecond Nd:YAG laser. Clin Exp Optom 2020; 103:908-910. [DOI: 10.1111/cxo.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 11/03/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Isen Hayashi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan,
| | - Kei Mizobuchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan,
| | - Akira Watanabe
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan,
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan,
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Birtel J, Hildebrand GD, Charbel Issa P. Laser Pointer: A Possible Risk for the Retina. Klin Monbl Augenheilkd 2020; 237:1187-1193. [DOI: 10.1055/a-1250-8471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
AbstractIn recent years, an increasing incidence of laser pointer-associated retinal injuries has been observed, likely due to easy access to incorrectly classified laser pointers, their labelling as toys, and lack of awareness concerning the associated risk. Laser pointer exposure can lead to irreversible retinal damage and associated vision loss, depending on the wavelength, radiation power, duration of exposure, localization, and spot size. Pronounced retinal laser damage is especially seen in children and teenagers. The structural appearance of retinal laser pointer damage varies and, in some cases, may be a diagnostic challenge. Besides often subtle findings on optical coherence tomography examination, characteristic alterations on near-infrared autofluorescence imaging may be valuable for the diagnosis of retinal laser pointer injuries and for differentiating other retinal lesions with similar appearance. The increase in laser pointer injuries indicates that regulatory
actions and increased public awareness are required regarding the dangers of laser pointers.
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Affiliation(s)
- Johannes Birtel
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - G. Darius Hildebrand
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Peter Charbel Issa
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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39
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Hamilton MM, Kao R. Recognizing and Managing Complications in Laser Resurfacing, Chemical Peels, and Dermabrasion. Facial Plast Surg Clin North Am 2020; 28:493-501. [PMID: 33010868 DOI: 10.1016/j.fsc.2020.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Skin resurfacing techniques allow improvement of skin texture and color. This includes the effacement of wrinkles, signs of photoaging, and the softening of scars. Laser resurfacing, chemical peels, and dermabrasion are associated with overlapping risks of complications. The most common of these include infection, hypopigmentation, hyperpigmentation, and scarring. Patient evaluation helps provide treatment that gives the maximal benefit with a minimization of risks. This includes understanding the extent of each patient's issues (Glogau scale) and Fitzpatrick type. A thorough knowledge of potential risks will reduce their incidence and optimize early recognition and treatment of these complications when they do occur.
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Affiliation(s)
- Mark M Hamilton
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, 340 West 10 th Street, Fairbanks Hall, Suite 6200, Indianapolis, IN 46202-3082, USA.
| | - Richard Kao
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, 340 West 10 th Street, Fairbanks Hall, Suite 6200, Indianapolis, IN 46202-3082, USA
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40
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Rono C, Oliver TR. Near infrared light exposure is associated with increased mitochondrial membrane potential in retinal pigmented epithelial cells. Photochem Photobiol Sci 2020; 19:1455-1459. [PMID: 33000839 DOI: 10.1039/d0pp00168f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The goal of this study was to characterize the effect of near-infrared light exposure on mitochondrial membrane potential, in vitro. We focused on the retinal pigmented epithelial (RPE) cells due to our interest in the visual health of military airmen exposed to infrared light, which causes thermal damage to the retina. Within RPE cells, an irradiance of 1.6 mW cm-2 for 30 minutes, resulting in a total fluence of 2.88 J cm-2, induces resistance to cell death in retinal pigmented epithelial cells exposed to a 1-sec hazardous pulse of 2 μm laser radiation 1. Thus, we examined the impact of this exposure on mitochondrial membrane potential in RPE cells. To do this, the fluorescent molecule, tetramethylrhodamine ethyl ester (TMRE), was used to quantify mitochondrial membrane potential. TMRE is a cell permeant, positively-charged, red-orange dye that readily accumulates in active mitochondria due to their relative negative charge. Depolarized or inactive mitochondria have decreased membrane potential and fail to sequester TMRE. Data from our study show that RPE cells exposed to an irradiance of 1.6 mW cm-2 for 30 minutes demonstrate elevations in mitochondrial membrane potential. This is the expectation if NIR light exposure is associated with oxygen consumption, as shown in previously published studies. Thus, by focusing on the uptake of TMRE in mitochondria, our findings provide additional details regarding the mechanism underlying the effect of NIR and potentially PBM in RPE cells. These findings may also apply to other cell types and red and NIR light exposures.
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Affiliation(s)
- Catherine Rono
- Department of Biology, Spelman College, Atlanta, GA, 350 Spelman Lane, Atlanta, GA 30314, USA.
| | - Tiffany R Oliver
- Department of Biology, Spelman College, Atlanta, GA, 350 Spelman Lane, Atlanta, GA 30314, USA.
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Abstract
PURPOSE To study the etiology, clinical features, management options, and visual prognosis in various types of atypical macular holes (MHs). METHODS A review of the literature was performed, which focused on the etiopathogenesis of atypical or secondary MHs, their differentiating clinical features, management strategies, and varied clinical outcomes. Idiopathic or age-related, myopic, and traumatic MHs were excluded. RESULTS Atypical or secondary MHs arise out of concurrent ocular pathologies (dystrophy, degeneration, or infections) and laser/surgery. The contributing factors may be similar to those responsible for idiopathic or typical MHs, i.e., tangential or anteroposterior vitreofoveal traction or cystoid degeneration. The management is either observation or treatment of the underlying cause. The prognosis depends on the background pathology, duration of disease, and baseline visual acuity governed by the size of MH and morphologic health of underlying RPE and photoreceptors. The closer the morphology of atypical MH is to that of an idiopathic MH, the better the surgical outcome is. CONCLUSION With the advancements in retinal imaging, atypical MHs are now more frequently recognized. With increasing understanding of the underlying disease processes, and improvement in investigations and surgical treatment, management of atypical MHs may improve in the future.
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Tong JY, Pasick LJ, Benito DA, Sataloff RT. Adverse Events Associated With Laser Use in the Upper Airway. Otolaryngol Head Neck Surg 2020; 164:911-917. [PMID: 32660346 DOI: 10.1177/0194599820938743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Surgical lasers are used extensively in head and neck surgery. Laser use in the upper airway offers many advantages but also presents risks to patients and operators that are not reported comprehensively. This study aims to summarize device malfunctions, patient complications, and subsequent interventions related to laser use in the upper airway. METHODS The US Food and Drug Administration's Manufacturer and User Facility Device Experience database was queried for reports of surgical laser adverse events from January 2010 to March 2020. Data were extracted from reports pertaining to the upper airway. RESULTS Sixty-two reports involving upper airway laser use in an operating room were identified, from which 95 events were extracted. Of these, 40 (42.1%) were adverse events to patients, 2 (2.1%) adverse events to operators, and 53 (55.8%) device malfunctions. Dislodgement of laser fiber in the airway (23 [57.5%]), burn (8 [20%]), and scar (5 [12.5%]) were the most common adverse events to patients. Two incidents of eye exposure through unfiltered microscope lenses were the only adverse events to operators. Fiber break (26 [49.1%]) and flare (12 [22.6%]) were the most common device malfunctions. DISCUSSION Surgical lasers have demonstrated utility in head and neck surgery but are associated with risks. This study discusses adverse events and device malfunctions associated with airway laser surgery and emphasizes shortcomings in current reporting. IMPLICATIONS FOR PRACTICE Standardized reporting and multi-institutional research are needed to better understand adverse events related to surgical laser use and to allow accurate estimation of their prevalence.
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Affiliation(s)
- Jane Y Tong
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Luke J Pasick
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.,Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Daniel A Benito
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.,Lankenau Institute for Medical Research, Philadelphia, Pennsylvania, USA
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Amoroso F, Souied EH, Ansary MF, Astroz P, Mouallem-Bézière A, Pedinielli A, Miere A. Optical coherence tomography angiography findings of choroidal neovascularization secondary to laser injury: A case report. Am J Ophthalmol Case Rep 2020; 19:100767. [PMID: 32548336 PMCID: PMC7286982 DOI: 10.1016/j.ajoc.2020.100767] [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: 05/09/2019] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose To report a case of choroidal neovascularization (CNV) secondary to laser injury imaged by optical coherence tomography angiography (OCTA) and treated by intravitreal anti-vascular endothelial growth factor (VEGF). Observations A 14-year-old boy presented with vision loss and central scotoma in the right eye (RE) in the last month, after having stared at the beam of a laser pointer. At presentation, his best-corrected visual acuity (BCVA) in the RE was 20/40 and spectral-domain OCT (SD-OCT) showed an interruption of ellipsoid zone and the presence of an hyperrelfective lesion in subfoveal region. OCTA examination revealed the presence of a high-flow lesion on both outer retina to choriocapillaris (ORCC) and choriocapillaris segmentations. The patient was treated by one anti-VEGF injection: at one month follow-up his BCVA in the RE was 15/20. SD-OCT revealed the complete resolution of hyperreflective lesion and no detectable flow on OCTA. Conclusions and Importance Retinal laser injury may be complicated by CNV. OCTA may non-invasively assess the presence of CNV, as well as treatment-response.
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Affiliation(s)
- Francesca Amoroso
- Department of Ophthalmology, Intercity Hospital and Paris Est University, Créteil, France
| | - Eric H Souied
- Department of Ophthalmology, Intercity Hospital and Paris Est University, Créteil, France
| | - Meryem Filali Ansary
- Department of Ophthalmology, Intercity Hospital and Paris Est University, Créteil, France
| | - Polina Astroz
- Department of Ophthalmology, Intercity Hospital and Paris Est University, Créteil, France
| | | | - Alexandre Pedinielli
- Department of Ophthalmology, Intercity Hospital and Paris Est University, Créteil, France
| | - Alexandra Miere
- Department of Ophthalmology, Intercity Hospital and Paris Est University, Créteil, France
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Diafas A, Stampouli D, Dastiridou A, Androudi S, Brazitikos P. Alexandrite Laser-Induced Choroidal Neovascularization Successfully Treated With Aflibercept. Cureus 2020; 12:e8294. [PMID: 32601568 PMCID: PMC7317130 DOI: 10.7759/cureus.8294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 33-year-old female was referred to the ophthalmology department after an accidental eye injury to her right eye during a hair removal session using alexandrite laser. Although she initially experienced no symptoms, when re-examined one and a half months later the best-corrected visual acuity (BCVA) of the affected eye was 20/40 secondary to choroidal neovascularization confirmed by fluorescein angiography (FA) and optical coherence tomography (OCT). Intravitreal anti-vascular endothelial growth factor (VEGF) therapy (three monthly injections of aflibercept) led to complete regression of the neovascularization and functional recovery which was maintained at one-year follow-up post original injury.
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Affiliation(s)
- Asterios Diafas
- Ophthalmology, Papageorgiou General Hospital / Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | - Anna Dastiridou
- Ophthalmology, Papageorgiou General Hospital / Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | - Periklis Brazitikos
- Ophthalmology, Papageorgiou General Hospital / Aristotle University of Thessaloniki, Thessaloniki, GRC
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Balikoglu-Yilmaz M, Kaya M, Erbezci M, Kaynak S. Rapid response to systemic steroid in macular alexandrite laser exposure: Multimodal imaging. Eur J Ophthalmol 2020; 31:NP30-NP35. [PMID: 32423336 DOI: 10.1177/1120672120924346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE To report the management of accidental macular photocoagulation during a 750-nm Alexandrite laser hair removal procedure. METHODS Single case report with images. RESULTS A 23-year-old girl presented with an immediate visual field defect in her right eye after direct inadvertent exposure to a single discharge from a 750-nm Alexandrite laser used for laser hair removal. Baseline Snellen visual acuity was 20/20 in the involved right eye but the patient reported a subjective visual field defect. She was treated with oral methylprednisolone that was started at a dose of 1 mg/kg/day and then gradually reduced. Six months after the initial exposure, the final visual acuity was 20/20 and there was a significant improvement in the macular lesion. However, the subjective visual field defect continued. She underwent multimodal retinal imaging with optical coherence tomography, fundus fluorescence angiography, and optical coherence tomography angiography in addition to a visual field test and microperimety. CONCLUSION The present case documents a gradual visual and anatomical improvement following macular photic damage after accidental occupational exposure to a 750-nm Alexandrite laser. The treatment should be arranged according to the localization of the laser damage. Optical coherence tomography angiography also has the potential to help noninvasively detect choriocapillaris damage.
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Affiliation(s)
- Melike Balikoglu-Yilmaz
- Department of Ophthalmology, Faculty of Medicine, Izmir Katip Çelebi University, Izmir, Turkey
| | - Mahmut Kaya
- Department of Ophthalmology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Suleyman Kaynak
- Department of Ophthalmology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Tran K, Wang D, Scharf J, Sadda S, Sarraf D. Inner choroidal ischaemia and CNV due to handheld laser-induced maculopathy: a case report and review. Eye (Lond) 2020; 34:1958-1965. [PMID: 32203244 DOI: 10.1038/s41433-020-0830-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/18/2019] [Indexed: 12/28/2022] Open
Abstract
There has been a sharp rise of reported handheld laser-induced maculopathy (HLIM) cases over the past decade, a concerning trend that may continue due to unregulated online access to high power lasers. Though HLIM has distinct clinical features, not uncommonly it may masquerade as other retinal disorders. It is critical therefore to recognise the clinical and multimodal imaging characteristics of this important and potentially devastating condition. As HLIM patients are typically young, unique issues need to be considered, such as delayed presentation, difficult history, poor compliance and behavioural or psychiatric comorbidity. This article will review the clinical and diagnostic features of laser injury, with a special emphasis on the multimodal retinal findings. In addition, we present a unique case of HLIM, resembling the presentation of a placoid disease variant and illustrating choroidal ischaemia using advanced retinal imaging, that offers further insight into the mechanisms of laser injury and its complications. The issues addressed in this review aim to increase recognition of an increasingly important and trending condition with potentially profound visual complications.
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Affiliation(s)
- Khoi Tran
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Derrick Wang
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Jackson Scharf
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - SriniVas Sadda
- Department of Ophthalmology, Doheny Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - David Sarraf
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA. .,Greater Los Angeles VA Healthcare Center, Los Angeles, CA, USA.
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Nghiem-Buffet S, Gaudric A, Cohen SY. Solar retinal phototoxicity masquerading as self-inflicted handheld laser-induced lesions. Am J Ophthalmol Case Rep 2020; 17:100578. [PMID: 31909293 PMCID: PMC6939100 DOI: 10.1016/j.ajoc.2019.100578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/04/2019] [Accepted: 12/11/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To report multimodal imaging of lesions due to the unprotected observation of the sun with an astronomical telescope, mimicking self-inflicted handheld laser-induced macular lesions. OBSERVATION A 44-year old man was diagnosed with chronic central serous chorioretinopathy leaving a relative scotoma in his left eye, with visual acuity limited to 20/40. He complained of a sudden visual loss to 20/400. Fundus examination showed a yellowish discoloration of the fovea. Fundus autofluorescence pictures showed hyper-autofluorescent spots that were hyperfluorescent both on fluorescein and indocyanine-green angiography. Spectral-domain optical coherence tomography (SD-OCT) showed hyper-reflective foveal outer layers, and OCT-angiography showed dark areas at the choriocapillaris. Multimodal imaging was highly suggestive of self-inflicted handheld laser-induced lesions that were ruled out by the patient. He remembered having observed the sun during an astronomical session, looking for solar winds. The main astronomical telescope was protected by a specific filter, but the aiming side-telescope was incidentally not protected by any filter. CONCLUSION AND IMPORTANCE The unprotected observation of the sun with an astronomical telescope may result in visual loss due to macular burns that may mimic self-inflicted handheld laser-induced lesions. This hypothesis should be searched before concluding denied self-injuries.
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Affiliation(s)
- Sylvia Nghiem-Buffet
- Ophthalmology Center for Imaging and Laser, 11 Rue Antoine Bourdelle, 75015, Paris, France
- Department of Ophthalmology, University of Paris 13, Avicenne Hospital, 125 Route de Stalingrad, 93000, Bobigny, France
| | - Alain Gaudric
- Ophthalmology Center for Imaging and Laser, 11 Rue Antoine Bourdelle, 75015, Paris, France
- Department of Ophthalmology, Lariboisière Hospital, AP-HP and University Paris 7, 2 Rue Ambroise Paré, 75010, Paris, France
| | - Salomon Y. Cohen
- Ophthalmology Center for Imaging and Laser, 11 Rue Antoine Bourdelle, 75015, Paris, France
- Department of Ophthalmology, Intercity Hospital and University Paris Est, 40 Avenue de Verdun, 94010, Creteil, France
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Flood TP, Flood CT. MACULAR BURN DURING AN ATTEMPTED YAG LASER CAPSULOTOMY BY INADVERTENT USE OF SELECTIVE LASER TRABECULOPLASTY MODE OF A DUAL-MODE LASER. Retin Cases Brief Rep 2020; 14:224-227. [PMID: 29261556 DOI: 10.1097/icb.0000000000000680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE To present a case of a patient who suffered a macular burn after an attempted YAG laser capsulotomy because of the inadvertent use of the selective laser trabeculoplasty mode of a dual-mode laser. METHOD Case report. RESULTS A 62-year-old man with slight opacification of the posterior capsule noted sudden central vision loss immediately after an attempted YAG laser capsulotomy. The selective laser trabeculoplasty mode of a dual-mode laser had inadvertently been used. Color photographs, fluorescein angiography, and spectral domain optical coherence tomography revealed a laser burn in the macula. The patient's central vision was impaired. CONCLUSION Inadvertent selection of the selective laser trabeculoplasty mode when attempting to perform a YAG laser capsulotomy with a dual-mode laser may cause a macular burn with impairment of central vision. We encourage all users of dual-mode lasers to actively choose and verify the appropriate settings to minimize the risk of inadvertent retinal damage.
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Affiliation(s)
- Timothy P Flood
- Department of Ophthalmology, Rush Medical College, Rush University, Chicago, Illinois; and
| | - Colin T Flood
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut
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Yang YH, Chung YT, Kim BK, Moon JH, Mun SJ. Inverted internal limiting membrane flap technique and an autologous platelet concentrate to treat an Nd: YAG laser-induced macular hole: A case report. Medicine (Baltimore) 2019; 98:e18185. [PMID: 31764860 PMCID: PMC6882603 DOI: 10.1097/md.0000000000018185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONALE Nd:YAG laser-induced macular holes (MHs) feature more extensive anatomical defects and worse functional outcomes than idiopathic MHs. Although new treatment options for large refractory MHs have been suggested, the current literature on Nd:YAG laser-induced MHs suggests only conventional pars plana vitrectomy combined with internal limiting membrane (ILM) peeling, which is the same treatment as for idiopathic MHs. PATIENT CONCERNS A 40-year-old dermatologist was referred to us because of a sudden decrease in visual acuity following exposure to a floor-tile-reflected single-shot Nd:YAG laser beam while not wearing protective goggles. DIAGNOSES An Nd:YAG laser-induced MH was diagnosed based on fundoscopy and optical coherence tomography (OCT). INTERVENTIONS Pars plana vitrectomy using an inverted ILM flap technique and autologous platelet concentrate (APC) was performed. OUTCOMES Postoperative spectral domain OCT and en-face OCT showed "U-shaped" closure of the MH and a decreased ellipsoid zone defect, while the best-corrected visual acuity improved from 20/500 to 20/25. LESSONS The inverted ILM flap technique combined with APC is an effective option to achieve successful MH closure and visual improvement in patients with an Nd:YAG laser-induced MH.
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Wang M, Wang Z, Xu X, Duan S, Du C. Tin diselenide-based saturable absorbers for eye-safe pulse lasers. NANOTECHNOLOGY 2019; 30:265703. [PMID: 30889561 DOI: 10.1088/1361-6528/ab1115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Eye-safe pulse lasers have attracted increasing attention due to their potential wide application in many fields. However, optical modulators with excellent nonlinear optical absorption properties in the range of 1.4-2.1 μm are still very scarce. In this study, tin diselenide (SnSe2), a newly-developed 2D layered semiconductor material with facile processability and low cost, was investigated. The nonlinear optical response of SnSe2 was investigated using the open aperture Z-scan method at 1500 and 1800 nm. Using SnSe2 as the saturable absorber, a passive Q-switched solid-state laser was realized at 1.3 and 1.9 μm for the first time. This study proved SnSe2 to be an effective optical modulating material for the eye-safe waveband.
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Affiliation(s)
- Mengxia Wang
- State Key Lab of Crystal Materials, Shandong University, Jinan, 250100, People's Republic of China
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