[Eye injuries caused by lasers in military and industrial environment. Apropos of 13 cases].

PURPOSE

The aim of this study was to analyse the nature of wavelengths used by military forces, evaluate their clinical consequences in terms of ocular risk, and determine the therapeutic implications and specific preventative measures which should be implemented both in peace- and war-time-settings.

MATERIAL AND METHODS

We analyzed retrospectively 13 cases of laser injury (12 patients) treated in our unit over the past 10 years. We recorded the characteristics of the responsible lasers, effects on visual acuity and visual filed, initial ophthalmoscopic and angiographic aspects, treatment undertaken and patient follow-up.

RESULTS

Wavelengths were know in only 10 cases. In 9 cases a NdYag laser operating at 1063 nm was involved. The tenth case was an Argon Coirorint laser accident. In three cases the wavelength could not be ascertained because it was confidential information or had been emitted by the enemy and had not been identified. Ocular injury was bilateral in 1 case and unilateral in 12. Retinal lesions were foveolar in 8 cases with an initial visual acuity varying from 1/10 to 10/10. Visual loss depended on the extent of the burn and did not tend to improve despite vasoprotector and corticosteroid treatments. In 2 cases the injury progressed without formation of an epimacular membrane. Retinal lesions were extra-foveolar in 5 cases and in 1 case vitreous hemorrhage required vitrectomy.

CONCLUSION

With the widespread use of Yag lasers and the soon to be employed tuneable lasers, there in major risk of serious ocular injury resulting from foveolar burns or peripheral retina trauma with vitreous hemorrhage. In a war situation, a large number of laser casualties producing peripheral vitreous hemorrhage would create an important logistics problem for vitrectomy. The accent must therefore be focused on prevention. Personnel must be informed of the danger and instructed in wearing filter glasses adapted to the wavelengths being used, if known, or a universal photoactivated protective device, as yet a hypothetical possibility.