Periocular CO2 laser resurfacing: severe ocular complications from multiple unintentional laser impacts on the protective metal eye shields
| Autor: | Wei-Yong Wang, H. A. Martino Neumann, Ton G. van Leeuwen, Rudy M.M.A. Nuijts, Martin J. C. van Gemert, Albert Wolkerstorfer, Cees W. M. van der Geld, Paul R. Bloemen, Hayri Hortoglu, Martine J. Jager, Daniel M. de Bruin |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
genetic structures Dermatology Corneal ulceration Eye injuries law.invention 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine law Ophthalmology Cornea Medicine Iris (anatomy) Co2 laser business.industry Superficial Lesion medicine.disease Laser eye diseases medicine.anatomical_structure Lens (anatomy) 030221 ophthalmology & optometry Surgery sense organs business |
| Zdroj: | Lasers in Surgery and Medicine. 50:980-986 |
| ISSN: | 0196-8092 |
| DOI: | 10.1002/lsm.22951 |
| Popis: | Background and objectives A 36-year-old woman underwent CO2 laser resurfacing for periocular rhytides using protective stainless steel Cox II ocular shields. Immediately after the treatment, corneal lesions were seen in both eyes. The left eye subsequent developed corneal ulceration and scarring, a deformed iris, cataract, and lower eye lashes showing signs of acute burns. The right cornea had a small inferior mid-peripheral superficial lesion and concomitant lower mid-peripheral burned eye lashes. Our objective was to determine the most likely cause of these ocular complications. Study We estimated temperature-time combinations that could induce corneal injury and cataract. Heat conduction effects from a heated cornea to the lens and from a heated ring of periocular skin to the cornea were computed. The temperature response of a shield following CO2 laser irradiation was determined. Results We computed that cataract can develop when the corneal temperature reaches, for example, 80 °C for 14 seconds. A periocular ring of heated skin contributes little to the corneal temperature. After 7 pulses of consecutive CO2 laser bursts in 7.5 seconds, the total shield area already reached a homogeneous temperature of 63 °C. Conclusion Despite uncertainties in procedural details and modeling of cataract temperatures, the eye injuries were caused beyond doubt by heating of tear-covered metal eye shields by at least 10 consecutive but unintentional laser impacts. Lasers Surg. Med. 50:980-986, 2018. © 2018 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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