http://eyeconsultantspalmbeach.com/Port ... _Light.pdf
Ocular Damage Secondary to Intense Pulse Light Therapy to the Face
Wendy W. Lee, M.D.*, Jennifer Murdock, B.S.†, Thomas A. Albini, M.D.*, Terrence P. O’Brien, M.D.‡,
and Michael L. Levine, M.D.*
*Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine;
†University of Miami Miller School of Medicine, Miami; and ‡Department of Ophthalmology, Bascom Palmer Eye
Institute, University of Miami Miller School of Medicine, West Palm Beach, Florida, U.S.A.
Purpose: To promote awareness and prevention of ocular damage that can occur during Intense Pulsed Light (IPL) treatments of the periocular areas.
Methods: A retrospective chart review was conducted of 2 cases involving ocular damage following IPL procedures that were treated at Bascom Palmer Eye Institute for ocular complications.
Routine data were collected during ophthalmic examinations.
Results: Case 1: A 36-year-old female presented with eye pain, marked pupillary constriction, and anterior uveitis an hour after receiving IPL treatment to the face. Within 1 month, the damage had progressed to posterior synechiae and iris transillumination defects. She continues to have pain and severe photophobia due to permanent iris atrophy and transillumination that have persisted for years.
Case 2: A 27-year-old female presented with severe eye pain, vision disturbances, pupillary defects, and anterior uveitis 3 days after IPL of an eyelid freckle. At 2 months follow up, the iris and pupillary defects remain permanent. The patient continues to suffer from photophobia and pain.
Conclusions: The pigmented iris absorbs light in the same wavelength range of IPL, thus remaining vulnerable to IPL exposure, especially when applied to the periocular area. The fact that IPL is not a laser may give people a false sense of security regarding damage to the eye. The cases presented give evidence that periorbital IPL treatment may permanently affect pigmented intraocular structures. It is imperative for treating physicians to be aware of these hazards and to use appropriate eye protection to prevent ocular damage.
(Ophthal Plast Reconstr Surg 2011;0:000–000)
Intense pulsed light (IPL) is a popular technology used in the field of cosmetic medicine for the treatment of telangiectatic lesions, skin pigmentation, and abnormal skin texture. The popularity of IPL treatments is consistently increasing as more patients favor noninvasive and nonablative treatments with successful outcomes. Patients seek treatment most often for the face but also for areas such as the hands, neck, and chest.
IPL functions in the spectrum of wavelengths from 500 to 1200 nm, targeting structures of the skin, such as pigment and hemoglobin,
that absorb light within this range.1 Standard care during IPL therapy includes ophthalmic protection for everyone in the treatment room. Transparent eye goggles with the appropriate filters should be worn by the caregiver, and nontransparent eye shields, whether adhesive or not, should be placed on the patient. On occasion the caregiver may elect to remove, reposition, or even not use eye protection when treating in the periorbital area to reach specific smaller spaces, the access to which is obstructed by the anatomy and the limited flexibility of the IPL probe. Also, protective eyewear may not be worn when treating off the face, as the distance between the treatment area and the eyes creates a false sense of security. Neglect for appropriate eye protection during IPL can easily cause
ocular damage, albeit rarely reported. While commonly reported adverse events due to IPL exposure include abnormal dermatologic effects and pain,1 a new concern for ocular safety is growing as incidents of eye injury begin to surface.2,3 Damage to the eye from laser treatments has been well documented, 4 but to our knowledge, damage from IPL has not been widely discussed in the literature and has not been previously published in the ophthalmology literature. We present 2 different cases of permanent ocular damage secondary to IPL treatment, resulting in iris transillumination defects, pupil abnormalities, and anterior uveitis.