Preventing Eye Injuries From Light and Laser-Based Dermatologic Procedures: A Practical Review.

The light and laser-based devices used in cosmetic dermatology practice carry a risk of serious ocular injury if appropriate safety measures are not put in place. Currently there is a lack of enforced regulation around the use of these devices. This raises concerns for the handling of these devices by operators who may not have adequate training and qualifications. There is also no mandated reporting of adverse events, thus precluding determination of the true incidence of laser-induced ocular injuries. To decrease the risk of ocular and periocular laser-induced injuries, several practical measures can be implemented within the clinical setting. Scientific articles were identified by performing a literature review using terms relevant to laser eye safety and a narrative review was performed. This article explores several components of laser eye safety: patient screening and informed consent, clinical environment considerations, operator considerations, protective eyewear selection for operators and patients, when to use a corneal shield, how to place a corneal shield and what to do in the event of a suspected eye injury. It is our prerogative that a functional understanding of the scientific underpinnings of laser eye safety coupled with observance of published standards has the potential to reduce incidents.

Does Topical Anesthesia Alter the Outcomes of Vascular Laser Procedures? Review of Vasodynamic Effects and Clinical Outcomes Data.

BACKGROUND: Topical anesthesia has vasodynamic effects within the skin and therefore has the potential to change the presence of hemoglobin as a chromophore before intense pulsed light (IPL) and vascular laser treatments. It is unclear whether this is clinically relevant. Global consensus on the use of topical anesthetics in this context is lacking. OBJECTIVE: Review the effects of topical anesthetics on the skin microvasculature and the clinical implications of such effects on vascular treatments. METHODS: PubMed and Medline searches were performed to identify studies examining the vasodynamic effects of topical anesthesia on skin and evaluating differences in efficacy of IPL and vascular laser treatments with or without topical anesthetic use. RESULTS: Published studies reveal variable effects of different topical anesthetic agents on skin microvasculature. Only 3 controlled studies that directly examined the effect of topical anesthesia on clinical outcomes for pulsed dye laser (PDL) treatment of vascular conditions were identified. They did not support a difference in clinical outcomes with or without the use of topical anesthesia before PDL treatment. CONCLUSION: Although topical anesthetic agents have vasodynamic effects within the skin, there is currently insufficient evidence to advise against their use before light and laser-based vascular treatments.