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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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2
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Meyer BI, Gutkind NE, Shoji MK, Rong AJ. Bilateral Thermal Keratopathy Due to Plasma Skin Regeneration. Ophthalmic Plast Reconstr Surg 2024; 40:e89-e91. [PMID: 38738721 DOI: 10.1097/iop.0000000000002618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
A 40-year-old woman underwent periocular plasma skin regeneration, a cosmetic treatment for periorbital rejuvenation. She subsequently developed bilateral thermal keratitis, manifesting as blurred vision, irritation, and redness, with a vision decrease to 20/60 and 20/50 in her OD and OS, respectively. Examination demonstrated bilateral large, irregular corneal epithelial defects and edema, necessitating treatment with amniotic membrane grafts, bandage contact lenses, and hypertonic saline. One year posttreatment, her visual acuity improved to 20/20 and 20/25, albeit with ongoing symptomatic dryness and bilateral anterior stromal haze. This case, as only the second reported instance of ocular damage from periocular plasma skin regeneration, underscores the need for heightened awareness of potential ocular complications following plasma skin regeneration and reinforces the importance of protective measures during periocular procedures.
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Affiliation(s)
- Benjamin I Meyer
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Naomi E Gutkind
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Marissa K Shoji
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
- Department of Oculofacial Plastic and Orbital Surgery, Shiley Eye Institute, University of San Diego California, San Diego, California, U.S.A
| | - Andrew J Rong
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
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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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Lambert LH, Tompkins BL, Uber IC, Kapoor KG, Ramsey DJ. Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern. BMC Ophthalmol 2024; 24:134. [PMID: 38532396 DOI: 10.1186/s12886-024-03383-z] [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: 08/24/2023] [Accepted: 03/06/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Laser skin resurfacing is a popular cosmetic procedure for noninvasive skin rejuvenation. Since health insurance plans often do not cover these types of procedures, patients often pay out of pocket. Consequently, there is an incentive to go abroad, where prices are more affordable. However, practitioners in destination countries may lack rigorous training on laser safety, regulatory oversight, or licensing, especially on devices used for "cosmetic" procedures. In certain cases, this can lead to tragic outcomes, especially when underqualified practitioners operate medical-grade laser devices. CASE PRESENTATION A 29-year-old woman suffered a retinal burn from a handheld Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser pulse device used to perform skin resurfacing treatment at a medical spa in Vietnam. The patient was not adequately informed about the potential risk to her vision and was not provided with any eye protection. A momentary, unintended laser exposure to the patient's right eye led to irreversible vision loss due to a macular burn. This incident caused immediate pain, followed by the sudden appearance of floaters, along with a retinal and vitreous hemorrhage. Despite treatment with off-label bevacizumab for the development of a choroidal neovascular membrane, vision remained at the level of counting fingers because of the presence of the macular scar. CONCLUSION When utilizing laser-based devices, it is crucial to employ safety measures, such as the wearing of safety goggles or the use of eye shields to protect ocular tissues from potential damage. The growing availability of cosmetic laser devices presents a substantial public health risk, because numerous operators lack adequate training in essential safety standards, or they neglect to follow them. Furthermore, patients seeking services abroad are subject to the regulatory practices of the destination country, which may not always enforce the requisite safety standards. Further research is needed to determine regional and global incidence of laser-related injuries to help direct educational and regulatory efforts.
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Affiliation(s)
- Lester H Lambert
- Department of Ophthalmology, Naval Medical Center Portsmouth, 620 John Paul Jones Cir, 23708, Portsmouth, VA, USA.
| | - Brett L Tompkins
- Department of Ophthalmology, Naval Medical Center Portsmouth, 620 John Paul Jones Cir, 23708, Portsmouth, VA, USA
| | - Ian C Uber
- Department of Ophthalmology, Naval Medical Center Portsmouth, 620 John Paul Jones Cir, 23708, Portsmouth, VA, USA
| | - Kapil G Kapoor
- Wagner Kapoor Institute, 1800 Republic Road, Suite 102, 23454, Virginia Beach, VA, USA
| | - David J Ramsey
- Department of Ophthalmology, Tufts University School of Medicine, 02111, Boston, MA, USA
- Division of Ophthalmology, Lahey Hospital & Medical Center, 1 Essex Center Drive, 01960, Peabody, MA, USA
- New England College of Optometry, Graduate Faculty, Boston, MA, 02115, USA
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Bonińska K. Dermatologic laser-induced ocular and periocular complications: a review. BMC Ophthalmol 2023; 23:419. [PMID: 37858054 PMCID: PMC10588089 DOI: 10.1186/s12886-023-03159-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/28/2023] [Indexed: 10/21/2023] Open
Abstract
This study aimed to discuss severe ocular and periocular complications after dermatological laser treatment. This literature review evaluated published journal articles (clinical trials or scientific reviews) extracted from electronic databases (MEDLINE and PubMed) and the reference lists of related articles. Individual eyeball structures, such as chromophores, were found to interact with laser radiation. The type of damage was found to be influenced by the wavelength emitted by the laser-active medium. Moreover, in the absence of proper protection of the eyeballs, the structures that are crucial for vision can be damaged. In conclusion, laser treatment can also cause serious and irreversible complications. Appropriate patient selection, intraoperative techniques, early identification, and interventions for adverse postoperative effects are crucial to avoid major complications and even blindness.
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Affiliation(s)
- Karolina Bonińska
- Miejskie Centrum Medyczne Jonscher, ul. Milionowa 14, 93-113, Łódź, Poland.
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Sullivan DA, da Costa AX, Del Duca E, Doll T, Grupcheva CN, Lazreg S, Liu SH, McGee SR, Murthy R, Narang P, Ng A, Nistico S, O'Dell L, Roos J, Shen J, Markoulli M. TFOS Lifestyle: Impact of cosmetics on the ocular surface. Ocul Surf 2023; 29:77-130. [PMID: 37061220 PMCID: PMC11246752 DOI: 10.1016/j.jtos.2023.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.
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Affiliation(s)
| | | | - Ester Del Duca
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | | | - Sihem Lazreg
- Lazreg Cornea and Ocular Surface Center, Blida, Algeria
| | - Su-Hsun Liu
- University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | - Alison Ng
- Centre for Ocular Research & Education, School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Steven Nistico
- Department of Dermatology, University Magna Graecia, Catanzaro, Italy
| | | | | | - Joanne Shen
- Department of Ophthalmology, Mayo Clinic in Arizona, Scottsdale, AZ, USA
| | - Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
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7
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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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8
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Flegel L, Kherani F, Richer V. Review of Eye Injuries Associated With Dermatologic Laser Treatment. Dermatol Surg 2022; 48:545-550. [PMID: 35333214 DOI: 10.1097/dss.0000000000003427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The eye is susceptible to damage during dermatologic laser treatments. OBJECTIVE Discuss the anatomy of the eye related to these procedures, the principles of laser-eye interactions, and ocular injuries reported with dermatologic laser treatments. METHODS PubMed and Embase searches were conducted to identify cases of eye injuries associated with dermatologic laser treatments. RESULTS One hundred nineteen cases of eye injury associated with dermatologic laser treatments were identified. Fifty-nine cases targeted the eyelid during resurfacing and caused ectropion, while 60 cases resulted from direct injury of ocular structures. In most of the cases of the latter, improper eye protection was used (44 of 60, 73%). In nearly all these cases, it was the patient who sustained a potentially avoidable ocular injury (52 of 60, 87%). Thirty-one patients had persistent ocular symptoms at follow-up (52%). The most common procedure in this context was laser hair removal of the face (35 of 60, 58%). Most of the cases developed injuries specific for the particular laser based on its wavelength and affinity to target certain ocular chromophores (59 of 60, 98%). CONCLUSION Most of the dermatologic laser-associated eye injury cases have occurred in the context of laser resurfacing or laser hair removal and are potentially preventable.
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Affiliation(s)
- Lisa Flegel
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Femida Kherani
- Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
- Heights Laser, Burnaby, British Columbia, Canada
| | - Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
- Pacific Derm, Vancouver, British Columbia, Canada
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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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10
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Kulick MI. Commentary on: Safety Guidelines Concerning the Use of Protective Eyewear and Gauze During Laser Procedures. Aesthet Surg J 2021; 41:1186-1188. [PMID: 33231606 DOI: 10.1093/asj/sjaa254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yan MK, Kocak E, Yoong K, Kam JK. Ocular injuries resulting from commercial cosmetic procedures. Clin Exp Optom 2020; 103:430-433. [DOI: 10.1111/cxo.12952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/02/2019] [Accepted: 07/12/2019] [Indexed: 12/28/2022] Open
Affiliation(s)
- Mabel K Yan
- Department of Ophthalmology, The Alfred Hospital, Melbourne, Victoria, Australia,
| | - Enis Kocak
- Department of Ophthalmology, The Alfred Hospital, Melbourne, Victoria, Australia,
| | - Kevin Yoong
- Department of Ophthalmology, The Alfred Hospital, Melbourne, Victoria, Australia,
| | - Jonathan K Kam
- Department of Ophthalmology, The Alfred Hospital, Melbourne, Victoria, Australia,
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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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Kim RY, Ra H. Observation of changes after peripheral retinal injury by cosmetic laser, using wide-field scanning laser ophthalmoscope: A case report. Medicine (Baltimore) 2019; 98:e14354. [PMID: 30732166 PMCID: PMC6380843 DOI: 10.1097/md.0000000000014354] [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: 11/26/2022] Open
Abstract
RATIONALE Increases in cosmetic laser use have led to recent reports of accidental retinal injuries, most of which are limited to the posterior pole. We report a case of peripheral retinal injury caused by a 1064-nm Nd:YAG: neodymium-doped yttrium aluminum garnet. PATIENT CONCERNS A 27-year-old Asian woman was admitted with scotoma symptoms in her right eye. The patient was a skin care technician. Three days before admission, a laser beam had struck her eye while she was preparing for a laser procedure. DIAGNOSIS During fundus examination, a subretinal hemorrhage with disc diameter (DD) of 4.0 and a preretinal hemorrhage of 2.5 DD in its center were found in the 2 o'clock position of the peripheral retina in the right eye. INTERVENTIONS We monitored the injury for > 6 months, first using fluorescein angiography, then wide-field scanning laser ophthalmoscopy and optical coherence tomography. Oral steroids and vitamins were administered. OUTCOMES During the 6-month follow-up period, blood from the initial sub- and preretinal hemorrhage, as well as vitreous hemorrhage, were all absorbed. Retinal detachment was not observed as scar formation and adhesions had occurred. No interventions were considered necessary. LESSONS When treating a patient who has experienced laser eye injury, the possibility of peripheral retinal injury should be considered. Peripheral retinal injury caused by 1064-nm Nd:YAG: neodymium-doped yttrium aluminum garnet has a relatively good prognosis, suggesting that it will not progress to retinal detachment.
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Klyuchareva SV, Ponomarev IV, Topchy SB, Pushkareva AE, Andrusenko YN. Treatment of basal cell cancer in the periorbital area using a pulsed copper vapour laser. VESTNIK DERMATOLOGII I VENEROLOGII 2018. [DOI: 10.25208/0042-4609-2018-94-6-15-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
An increase in life expectancy in developed countries is inevitably accompanied by an increase in the number of nonmelanoma skin diseases, which are primarily represented by basal cell cancer (BCC) occurring in elderly and old-age patients. The pathogenesis of such diseases is associated both with impaired proliferation and differentiation of the keratinocytes of the epidermal basal layer, as well as with the transformation of the vasculature in the papillary dermis in the vicinity of BCC. In recent years, such conditions have been increasingly treated using CO2 , neodymium, diode and pulsed-dye lasers. In many cases, these devices allow malignant BCC cells to be successfully eliminated. However, the use of near-infrared lasers in the periorbital area is limited due to a higher risk of damaging the organs of the visual system. Therefore, a search for new laser surgery methods that can be used for treating malignant skin tumours seems to be a prospective research direction.Methods. 3 male and 9 female patients diagnosed with primary BCC were treated using a copper vapour laser (Yakhroma-Med). The age of the patients varied from 34 to 77 years. Laser treatment was carried out in one session under the following irradiation parameters: the wavelength of 511 and 578 nm, the average power of up to 3 W and a series of 15 ns pulses. The pause between the pulses was 60 μs, with the exposure time ranging from 200 to 600 ms. The light spot diameter on the skin surface was 1 mm. The follow-up monitoring duration was 24 months.Results. In all the BCC patients, one session of copper vapour laser treatment allowed malignant cells in the disease area to be completely eliminated without relapses during 2 years after the therapy. The duration of skin healing in the irradiated area was 2 weeks in patients under the age of 40 years, compared to 3–4 weeks in elderly patients. After the treatment, short-term side effects, such as a slight edema, erythema and peeling, were observed.
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15
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Huang A, Phillips A, Adar T, Hui A. Ocular Injury in Cosmetic Laser Treatments of the Face. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2018; 11:15-18. [PMID: 29552271 PMCID: PMC5843357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND: The eye is a vulnerable and commonly injured organ in cosmetic laser procedures of the face. Treatment of the eyelids and periorbital areas increases this risk, especially when ocular protection devices are not used or are removed during the procedure. A study has shown that injury from laser epilation of the periocular areas is one of the most common causes of litigation in cutaneous laser surgery. OBJECTIVE: The goal of this review is to determine the causes of ocular injury in cosmetic laser procedures and derive lessons on critical safety elements to prevent future injury. METHODS: We conducted a review of the current literature through a PubMed search on case reports of ocular injury in cosmetic laser treatments of the face. Twenty-one cases are examined. RESULTS: In more than 62 percent of cases, ocular protection was not used or protection was used but removed during the procedure to treat areas close to the eye. However, despite the proper use of intraocular corneal shields and wavelength-specific goggles, accidents occurred in 33 percent of cases. CONCLUSION: Ocular protection devices are essential to prevent most cases of laser-induced eye injury. Use of high fluence and long wavelength lasers increases the risk of ocular injury due to deeper penetration of the organ by radiation. Inadequate cooling between pulses also predisposes to injury by cosmetic lasers.
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Affiliation(s)
- Amy Huang
- Drs. Huang, Adar, and Hui are with the Department of Dermatology at the State University of New York Downstate Medical Center in Brooklyn, New York
- Ms. Phillips and Dr. Hui are with Bay Area Cosmetic Dermatology in San Francisco, California
| | - Arianna Phillips
- Drs. Huang, Adar, and Hui are with the Department of Dermatology at the State University of New York Downstate Medical Center in Brooklyn, New York
- Ms. Phillips and Dr. Hui are with Bay Area Cosmetic Dermatology in San Francisco, California
| | - Tony Adar
- Drs. Huang, Adar, and Hui are with the Department of Dermatology at the State University of New York Downstate Medical Center in Brooklyn, New York
- Ms. Phillips and Dr. Hui are with Bay Area Cosmetic Dermatology in San Francisco, California
| | - Andrea Hui
- Drs. Huang, Adar, and Hui are with the Department of Dermatology at the State University of New York Downstate Medical Center in Brooklyn, New York
- Ms. Phillips and Dr. Hui are with Bay Area Cosmetic Dermatology in San Francisco, California
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Ricci LH, Navajas SV, Carneiro PR, Söderberg SA, Ferraz CA. Ocular adverse effects after facial cosmetic procedures: a review of case reports. J Cosmet Dermatol 2015; 14:145-51. [DOI: 10.1111/jocd.12141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Lucas H. Ricci
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
| | - Samia V. Navajas
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
| | - Paula R. Carneiro
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
| | - Stephanie A. Söderberg
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
| | - Caroline A. Ferraz
- School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
- Department Ophthalmology; School of Medicine; Anhembi Morumbi University; Laureate International Universities; São Paulo SP Brazil
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