Shum Jennifer W H, Iu Lawrence P L, Cheung Danny N, Wong Ian Y H
Department of Ophthalmology, The University of Hong Kong, Hong Kong, China.
Retin Cases Brief Rep. 2016 Spring;10(2):115-20. doi: 10.1097/ICB.0000000000000181.
To report the clinical course of a patient sustaining a ocular laser injury from 1,064-nm Nd:YAG cosmetic laser machine.
A 31-year-old beauty parlor aesthetician was operating an Nd:YAG cosmetic laser machine of 1,064 nm wavelength. However, the probe was held in the opposite direction, and on firing, the laser shot fired into her left eye. The patient heard a "pop" sound followed by immediate floaters and blurring of vision. Her clinical course was followed for 6 weeks, with investigations including optical coherence tomography, fluorescein angiogram, and Humphrey's visual field examination performed.
Optical coherence tomography taken over the injured area showed thickened retina and preretinal hyperreflectivities. Fluorescein angiogram showed hypofluorescence superonasal to the disk with late staining of vessels. Humphrey's visual field showed a dense scotoma emanating from the blind spot. The lesion eventually scarred down, and the patient's vision recovered.
The eye is the most susceptible body part to laser light injury. A review of reported laser accidents revealed the majority to be ocular injuries. The retina is particularly vulnerable, as laser light with wavelength between 400 nm and 1,400 nm is focused by the cornea and lens onto the retina, increasing the retinal irradiance as a result. Most injuries were parafoveal, suggesting that most injuries occurred during laser beam alignment. The prognosis is generally favorable. As laser use becomes more widespread and its application increasingly heterogeneous, regulation of laser use and monitoring of laser safety are crucial but at the same time challenging.
报告一名因1064纳米钕：钇铝石榴石美容激光机导致眼部激光损伤患者的临床病程。
一名31岁的美容院美容师正在操作一台波长为1064纳米的钕：钇铝石榴石美容激光机。然而，探头被反向握持，发射时激光束射入了她的左眼。患者听到“啪”的一声，随后立即出现飞蚊症和视力模糊。对其临床病程进行了6周的跟踪，期间进行了包括光学相干断层扫描、荧光素血管造影和汉弗莱视野检查在内的各项检查。
受伤区域的光学相干断层扫描显示视网膜增厚和视网膜前高反射率。荧光素血管造影显示视盘鼻上侧低荧光，血管晚期染色。汉弗莱视野显示从盲点发出的致密暗点。病变最终瘢痕化，患者视力恢复。
眼睛是最易受激光损伤的身体部位。对已报道的激光事故的回顾显示，大多数事故为眼部损伤。视网膜尤其脆弱，因为波长在400纳米至1400纳米之间的激光被角膜和晶状体聚焦到视网膜上，从而增加了视网膜的辐照度。大多数损伤发生在黄斑旁，这表明大多数损伤发生在激光束对准过程中。总体预后良好。随着激光的使用越来越广泛，其应用越来越多样化，激光使用的监管和激光安全的监测至关重要，但同时也具有挑战性。
