Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern
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 affordabl...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Ophthalmology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12886-024-03383-z |
| _version_ | 1797233740236193792 |
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| author | Lester H. Lambert Brett L. Tompkins Ian C. Uber Kapil G. Kapoor David J. Ramsey |
| author_facet | Lester H. Lambert Brett L. Tompkins Ian C. Uber Kapil G. Kapoor David J. Ramsey |
| author_sort | Lester H. Lambert |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T16:20:58Z |
| format | Article |
| id | doaj.art-4d2f815b192741d4b700557d982fa59e |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-04-24T16:20:58Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-4d2f815b192741d4b700557d982fa59e2024-03-31T11:13:25ZengBMCBMC Ophthalmology1471-24152024-03-012411710.1186/s12886-024-03383-zRetinal injury from a laser skin resurfacing device during medical tourism: a public health concernLester H. Lambert0Brett L. Tompkins1Ian C. Uber2Kapil G. Kapoor3David J. Ramsey4Department of Ophthalmology, Naval Medical Center PortsmouthDepartment of Ophthalmology, Naval Medical Center PortsmouthDepartment of Ophthalmology, Naval Medical Center PortsmouthWagner Kapoor InstituteDepartment of Ophthalmology, Tufts University School of MedicineAbstract 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.https://doi.org/10.1186/s12886-024-03383-zRetinaLaser injuryChorioretinal scarVitreomacular tractionNeovascular membraneSafety |
| spellingShingle | Lester H. Lambert Brett L. Tompkins Ian C. Uber Kapil G. Kapoor David J. Ramsey Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern BMC Ophthalmology Retina Laser injury Chorioretinal scar Vitreomacular traction Neovascular membrane Safety |
| title | Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern |
| title_full | Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern |
| title_fullStr | Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern |
| title_full_unstemmed | Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern |
| title_short | Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern |
| title_sort | retinal injury from a laser skin resurfacing device during medical tourism a public health concern |
| topic | Retina Laser injury Chorioretinal scar Vitreomacular traction Neovascular membrane Safety |
| url | https://doi.org/10.1186/s12886-024-03383-z |
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