
15510-EN Rev G Introduction 7
Potential Side Effects or Complications
Ophthalmic:
• Specifictoretinalphotocoagulation:inadvertentfovealburns;choroidalneovascularization;
paracentralscotomata;transientincreasededema/decreasedvision;subretinalfibrosis;
photocoagulationscarexpansion;Bruch’smembranerupture;choroidaldetachment;exudative
retinal detachment; pupillary abnormalities from damage to the ciliary nerves; and, optic neuritis
from treatment directly or adjacent to the disc.
• Specifictolaseriridotomyoriridoplasty:inadvertentcornealorlensburns/opacities;iritis;iris
atrophy; bleeding; visual symptoms; IOP spike; and, rarely, retinal detachment.
• Specifictolasertrabeculoplasty:IOPspike,and,disruptionofthecornealepithelium.
ENt:
Excessivetreatmentmaycauseswelling(edema)intheareatreatedbythelaser.
aNEsthEsia cONsidEratiONs:
One of the main concerns during otolaryngeal and bronchial procedures is the substantial risk of
endotracheal fires. The following sections provide information and safety guidelines, which can
greatly decrease the risks associated with these procedures. Information is also provided on what to
do if such a fire does occur.
IRIDEXCorp.recommendsthesafetyguidelinesofAmericanNationalStandardsANSIZ136.3-2007
as follows:
• Caremustbetakentoprotectendotrachealtubesfromlaserradiation.Ignitionorperforationof
endotracheal tubes by the laser beam could result in serious or fatal patient complications.
• Usethelowestpossibleoxygenconcentrationtosupportthepatient.
• Usetheventuriventilationtechniquewhenpossible.
• Useintravenousanestheticagentsratherthaninhalationtechniques.
• Usenon-flammablelaser-safeendotrachealtubes.
• Protecttheendotrachealtubecuffwithwetcottonoids.
Reference material and additional information regarding laser safety and the prevention of
endotracheal fires may be obtained from the following U.S. sources:
• ANSI Z136.3, The Safe Use of Lasers in Health Care Facilities,AmericanNational
Standards 2007.
• Recommended Practices: Laser Safety in the Practice Setting. AORN Journal, March 1993,
Vol.57No.3,Pg.720-727.
• Safety Considerations for the Use of Medical Lasers, The Nursing Spectrum of Lasers,
Pfister, Kneedler, Purcell, Education Design, 1988, Pg. 70-72.
• Prevention of Fires and Protection of Non-Target Tissues, Airway Precautions, Plan for
Success: A Practical Guide for Your Carbon Dioxide Laser Surgery Program, Lewis, Coherent 1989,
Pg. 16-17.
• Laser Resistant Stainless Steel Endotracheal Tube: Experimental and Clinical Evaluation,
Lasers in Surgery and Medicine, Fried, Marvin P., MD, 11:301-306 (1991).
• Evaluation & Discussion: Issues in Using and Selecting Laser Resistant Endotracheal
Tubes (LRETTs) and Wraps, ECRI, Health Devices,July-August1991,Vol.20Nos.7-8.
• Diffuse Reflections, Endoscopic Surgery: Is Laser Safety Eyewear Really Needed?, Radiant
Resources Newsletter, Winter 1992, Rockwell Laser Industries.