PDF(Pubmed)
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.
METHODS: 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.
CONCLUSIONS: 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.
METHODS: 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.
CONCLUSIONS: 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.
摘要：
背景：激光皮肤表面修复术是一种流行的非侵入性皮肤恢复美容程序。由于健康保险计划通常不涵盖这些类型的程序，病人经常自掏腰包。因此,有出国的动机，价格更实惠。然而,目的地国家的从业者可能缺乏严格的激光安全培训，监管监督,或许可，特别是在用于“美容”程序的设备上。在某些情况下,这会导致悲剧性的结果,尤其是当不合格的从业者操作医疗级激光设备时。
方法：一名29岁的妇女因手持调Q掺钕钇铝石榴石（Nd:YAG）激光脉冲装置在越南一家医疗水疗中心进行皮肤表面修复治疗而遭受视网膜烧伤。患者没有充分了解其视力的潜在风险，也没有提供任何眼睛保护。短暂的，由于黄斑烧伤，患者右眼意外激光照射导致不可逆的视力丧失。这一事件立即引起了痛苦，接着突然出现了漂浮物,还有视网膜和玻璃体出血.尽管使用非标签贝伐单抗治疗脉络膜新生血管膜的发展，由于黄斑瘢痕的存在，视力保持在计数手指的水平。
结论：使用基于激光的设备时，采取安全措施至关重要，例如佩戴安全护目镜或使用眼罩来保护眼部组织免受潜在损害。美容激光设备的日益普及带来了巨大的公共卫生风险，因为许多操作员缺乏基本安全标准的足够培训，或者他们忽视了跟随他们。此外，在国外寻求服务的患者必须遵守目的地国家的监管规定，这可能并不总是执行必要的安全标准。需要进一步的研究来确定区域和全球激光相关损伤的发生率，以帮助指导教育和监管工作。
方法：一名29岁的妇女因手持调Q掺钕钇铝石榴石（Nd:YAG）激光脉冲装置在越南一家医疗水疗中心进行皮肤表面修复治疗而遭受视网膜烧伤。患者没有充分了解其视力的潜在风险，也没有提供任何眼睛保护。短暂的，由于黄斑烧伤，患者右眼意外激光照射导致不可逆的视力丧失。这一事件立即引起了痛苦，接着突然出现了漂浮物,还有视网膜和玻璃体出血.尽管使用非标签贝伐单抗治疗脉络膜新生血管膜的发展，由于黄斑瘢痕的存在，视力保持在计数手指的水平。
结论：使用基于激光的设备时，采取安全措施至关重要，例如佩戴安全护目镜或使用眼罩来保护眼部组织免受潜在损害。美容激光设备的日益普及带来了巨大的公共卫生风险，因为许多操作员缺乏基本安全标准的足够培训，或者他们忽视了跟随他们。此外，在国外寻求服务的患者必须遵守目的地国家的监管规定，这可能并不总是执行必要的安全标准。需要进一步的研究来确定区域和全球激光相关损伤的发生率，以帮助指导教育和监管工作。
