Accidental macular injury from prolonged viewing of a plasma flash produced by a femtosecond laser.
OBJECTIVE
To report a case of macular injury caused by prolonged exposure to a flash from the plasma formed at the focus of a femtosecond laser.


METHODS
Interventional case report.


METHODS
A patient with macular injury caused by sustained observation of the plasma flash produced by a femtosecond laser.


METHODS
The patient was examined with complete ophthalmologic evaluation (including Amsler grid test, funduscopy, fluorescein angiography, and optical coherence tomography [OCT]) at 3 hours, 1 month, and 6 months after injury. The injured right eye received a retrobulbar injection of 40 mg triamcinolone acetonide (TransTon), at 4 hours and at 10 days after injury, respectively.


METHODS
Visual acuity, ophthalmoscopic, and OCT findings.


RESULTS
Three hours after injury, the best-corrected visual acuity of the right eye was 20/30 with a very small relative scotoma nasal to fixation. Funduscopy disclosed a well-circumscribed, yellow-white spot lesion located immediately temporal to the foveal center. As time passed, the patient's vision returned to 20/20 and the scotoma and retinal abnormalities had become less prominent, but were still present. In the acute stage, OCT showed a hyperreflective lesion involved all foveal retinal layers. At 1 and 6 months of follow-up, OCT revealed abnormal reflectivity located within the outer foveal retina.


CONCLUSIONS
Prolonged viewing of a plasma flash induced by a focused femtosecond laser in the air without eye protection may produce persistent damage to the retina. The observed macular injury was probably the result of a combination of thermal and photochemical damage.
Yang
Xiaobo
X
Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Jiang
Fagang
F
Song
Yanping
Y
Peng
Chong
C
Sheng
Shuangyan
S
Li
Xiaoqing
X
D000062:Accidents, Occupational; D000328:Adult; D005131:Eye Injuries / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007834:Lasers / Q000009:adverse effects*; D008297:Male; D009887:Ophthalmoscopy; D012160:Retina / Q000293:injuries*; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012607:Scotoma / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D014792:Visual Acuity
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide