Electromagnetic interference from lasers and intense light sources in the treatment of patients with artificial pacemakers and other implantable cardiac devices.

Measurements of the electric and magnetic field strengths surrounding six laser systems and one intense pulsed light system were carried out. The results were compared to exposure limits published by cardiac device manufacturers to assess the risk of electromagnetic interference to implantable cardiac devices such as pacemakers or implantable cardioverter defibrillators. The majority of lasers assessed in this study were found to produce electric and magnetic field strengths below the published exposure limits for cardiac devices. However, the low-frequency electric field and static magnetic field of both the CO2 laser and the ruby laser were found to exceed these limits. Ensuring that a small separation is maintained at all times between the laser unit and any patient with a pacemaker or implantable cardioverter defibrillator appears to be a sensible expedient in avoiding overexposure of an implantable cardiac device to electromagnetic interference. Due to the single-shot fast discharge nature of the intense pulsed light system, changes in electromagnetic field strength were too fast for some of the measuring equipment used in this study to register accurate readings during operation.

Cutaneous lasers and skin camouflage make-up: a useful alternative intervention for periorbital hairy congenital melanocytic naevus.

Periorbital congenital melanocytic naevi can be very disfiguring and difficult to treat effectively. Although surgical excision and reconstruction is the most widely accepted treatment strategy, we describe a case in which cutaneous lasers treatment followed by the application of cosmetic skin camouflage make-up provided an alternative solution delivering a good cosmetic improvement.

Adverse effects reported in pulsed dye laser treatment for port wine stains.

A retrospective study was conducted over a 762-day period to investigate the incidence of adverse effects following pulsed dye laser treatment for port wine stains using the Chromos 585 nm pulsed dye laser (PDL). Treatment energy densities typically ranged from 4.0 J/cm(2) to 7.5 J/cm(2). Treatment was predominantly delivered as a 7 mm-diameter pulse of laser light, although a 5 mm pulse was occasionally used. Nine patients experienced one adverse event each, with scabbing, blistering (prolonged in one case that persisted for more than 2 months), hypopigmentation or hyperpigmentation; one of the nine patients developed both blistering and hypopigmentation. The incidence of adverse effects per treatment was 1.4% (1.7% for adults and 0.6% for children). The lower leg was the most common site for an adverse effect; four out of 22 patients (18%) receiving PDL treatment for lower leg port wine stains (PWSs) suffered an adverse effect (three cases of hyperpigmentation and one of hypopigmentation and blistering). Four patients suffered an adverse effect following an increase in the energy density of the laser treatment. There was no statistically significant correlation between laser performance and the occurrence of adverse effects.