Ocular Complications After Laser or Light-Based Therapy—Dangers Dermatologists Should Know

Juhász, Margit; Zachary, Christopher B.; Cohen, Joel L.

doi:10.1097/dss.0000000000002974

Cited by 5 publications

(8 citation statements)

References 58 publications

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“…Early identification of the signs and symptoms is equally essential for both physicians and home device consumers to prevent further ocular damage and complications such as iris pigment flakes and subsequent glaucoma formation. Thought-provoking, in parallel with the reported laser-induced ocular injuries, 37 IPL-induced ocular injuries showed left-side laterality as well, which might be triggered by the patient’s position during the procedure in relation to the operator’s dominant hand.…”

Section: Discussionmentioning

confidence: 58%

Is It Possible for Light-Based Hair Removal Home Devices to Induce Ocular Damage? Systematic Review

Al muqarrab,

Alsuwaidan,

Al muqarrab

et al. 2023

CCID

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Light-based hair removal home devices emit intense pulse light (IPL) or Diode laser. While the Food and Drug Administration controls them in the US, Europe continues to classify them as cosmetic products. Emerging concerns are: what if an unprotected eye is inadvertently exposed to light emission? Or if the consumer tries to overcome the protective safety features? We performed this systematic review by searching the Medline, CENTRAL, and Google Scholar databases to investigate the ocular damage reported after exposure to IPL for hair removal. We could not identify any case reported following exposure to home devices; however, a total of 20 patients were identified with iris atrophy, anterior chamber inflammation, and/or retinal pigment epithelium damage following exposure to office IPL or Diode lights. 40% were not using any protective eyewear during the light procedure. The reported fluences were in the range of 20–24 J/cm 2 . Although the ocular damage was identified following office devices, the reported fluences were within the home device’s limits. For that, manufacturers should provide clear instructions on the package regarding the ocular hazards, the importance of using protective goggles, and a firm warning not to overcome the contact sensors. Home device-induced ocular damage is still a concern, perhaps under-reported.

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Section: Discussionmentioning

confidence: 58%

Is It Possible for Light-Based Hair Removal Home Devices to Induce Ocular Damage? Systematic Review

Al muqarrab,

Alsuwaidan,

Al muqarrab

et al. 2023

CCID

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“…The thin eyelid may act favorable for thermal transfer through metal eye shields and corneal epithelium. Reviews by Huang et al (2018) and by Juhasz et al (2021) revealed that in about 60% of reported cases, no proper eye protection or no further information on eye protection was provided [ 1 , 2 ]. This indicates growing evidence that insufficient safety measures are the cause for severe injuries in most cases.…”

Section: Discussionmentioning

confidence: 99%

“…To enable rapid ophthalmological interventions and thus reduce associated morbidity of patients, laser physicians should be aware of symptoms and signs associated with eye injuries. Symptoms occur immediately or shortly after laser treatment and present as visual abnormalities and pain followed by photophobia and visual glare [ 2 ]. Most common ophthalmologic findings were hyperemia of the eye and pupil irregularities [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Thermal eye injuries from dermatologic laser treatments—an experimental study

Nguyen

Seeber²,

Schneider

et al. 2023

Lasers Med Sci

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In recent years, severe ocular complications after dermatological laser therapies have been reported. One hypothesis is thermal damage due to heating of the metal eye shields. The aim of the present study is to evaluate the safety of ocular metal eye shields during laser therapy of the periocular region. For the experimental study, porcine eyelids were exposed to continuously increasing laser energy and multiple pulses using a number of dermatologic laser systems. Temperature differences of the convex and concave surface of metal eye shields were constantly measured using a thermocouple. Maximum increase of the convex surface of shields was + 8.9 °C (± 0.1 °C) provided by the long-pulsed alexandrite laser (20–25-J/cm2 energy, 15-mm spot size, 20-ms pulse duration, 1 Hz). Present data indicate that metal eye shields provide sufficient thermal protection when clinically used laser parameters are applied. Other safety precautions continue to be essential to protect both the patient and the laser operator. These include the use of nonreflective metal eye shields, precise knowledge of laser physics, and a clear understanding of how they interact with ocular and periocular anatomy.

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“…102 When using laser hair removal devices, especially on the face or the area around the eyes, both the patient and the laser operator must wear wavelength-specific goggles to prevent eye-related adverse effects. [103][104][105][106]…”

Section: Ocular Incidentsmentioning

confidence: 99%

Adverse Events of Light-Assisted Hair Removal: An Updated Review

et al. 2023

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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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Ocular Complications After Laser or Light-Based Therapy—Dangers Dermatologists Should Know

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 5 publications

References 58 publications

Is It Possible for Light-Based Hair Removal Home Devices to Induce Ocular Damage? Systematic Review

Is It Possible for Light-Based Hair Removal Home Devices to Induce Ocular Damage? Systematic Review

Thermal eye injuries from dermatologic laser treatments—an experimental study

Adverse Events of Light-Assisted Hair Removal: An Updated Review

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