Corneal burn injury in picosecond laser treatment: A potential hazard in cosmetic therapy

ABSTRACT To describe a case of picosecond laser-related corneal burn injury. Case presentation of a patient underwent picosecond laser cosmetic treatment, complicated with severe corneal burn injury. We evaluate patient’s visual acuity, corneal edema condition under slit lamp and corneal OCT (Optical coherence tomography), corneal shape with topography, and intraocular pressure. Picosecond laser emits optical pulses with duration between one to tens of picoseconds. The original purpose was to remove tattoos, but has now extended to a wide range of skin diseases and even cosmetic use. When applying cutaneous laser therapy, several ocular adverse events have been reported, mostly due to no appropriate ocular protection during treatment. We report a case of corneal burn injury after receiving picolaser therapy for a pigmented lesion over the upper lid. Severe cornea edema and vision impairment improved gradually after appropriate treatment. Even picosecond laser produce less thermal burns then other lasers, it is essential to use ocular protection during the entire treatment. According to our database search, this is the first picolaser-related ocular adverse event reported. Key Points Without appropriate protection, cosmetic laser treatments can cause severe ocular side effects and permanent visual impairment. We present this case to emphasize the importance of ocular protection during the entire treatment period, especially treatments of lesions over the eyelids. According to our knowledge and database search, this is the first reported ocular injury caused by picolaser.