We enrolled 152 infants aged 1 to 42 months old with infantile hemangioma by laser treatment in Tokyo Women’s Medical University Medical Center East Plastic surgery from January 2011 to September 2016. This time, we investigate complication of infantile hemangioma by laser treatment. The risk factor of it is concerned to be infantile hemangioma area ≥4 cm², number of times ≥6, premature baby.

A 38 year-old female nurse was training for laser toning by Nd:YAG laser. Accidental macular hole occurred in her right eye when she was exposing laser light on the training paper contained in a clear plastic file. She didn’t wear protective goggles. Macular hole was closed by vitrectomy, but the visual acuity of her right eye deteriorated to 0.01.

In the field of dermatology and plastic surgery, laser equipment have been more sophisticated and compact since the 1990s, and many types of medical laser equipment have become to be available. In addition, the number of manufacturers dealing with medical laser equipment has increased, making it easy to use medical laser equipment in many facilities. On the other hand, since the maintenance of medical laser equipment and the laser safety measures have not been so problematic, various accident reports concerning about the medical laser safety have been reported. In this manuscript, we introduce our 44-years’ efforts toward laser safety, and make a practical proposal on laser safety in our fields.

The laser treatment spreads widely now in dentistry domain, but it is necessary to consider it about safety and safeguard to prevent any accident at the narrow area of oral cavity. Many kinds of lasers heve been used at present, carbon dioxide, Nd:YAG, Er:YAG and diode laser are used most often. These laser applications require the use of high power to attain the desired thermal effects on biologic tissues. Excessive heat energy results in tissue and alveolar bone necrosis close to the irradiated area. Therefore, it is necessary to obtain sufficient knowledge about tissue interaction in advance before using the laser. Several cases were reported about subcutaneous emphysema following laser treatment in dentistry. It should be kept in mind that complications of iatrogenic subcutaneous emphysema may occur during surgical laser incision of abscess, whenever compressed cooling air-flow used inside the mouth. To avoid these complications for the use of dental laser are keep in mind of anatomical features of oral field and the basic knowledge and technique considering the feature of each laser.

In “Wearing safety eyewear” which is important as one of safety measures for laser processing workers, there must be no mistakes in the selection property safety eyewear for the laser work. The necessary items required for safety eyewear as mentioned above are not detailed in the Ministry of Health, Labor and Welfare Circular and are also described in JIS C 6802 “Safety Standards for laser Products”, but since the selection process of safety eyewear is not described, Based on the contents of these standards, I would like to refer to summarize the points to keep in mind when using safety eyewear for the laser as safety protection measures.

The author’s personal opinions about the current status and problems of safety education for laser medicine that is handled by the JSLSM Safety Education Committee are described. In addition to regular safety seminars three times a year, the committee supports safety seminars that are required by the government for approval of new medical laser devices. The committee also deals with the examination for qualification as laser medicine specialists, which are authorized by the JSLSM. The problem is that participants in the above-mentioned seminars are quite limited among the various physicians who are using medical laser devices. Drastic measures are needed to improve the safety of laser medicine.

It describes the guidelines for users in accordance with the safety standards for medical laser devices established by Japanese standards and international standards. The responsible person appoints a laser safety officer, and the laser safety officer sets up a laser safety management area. Laser safety officer perform risk assessments from incidents and accidents and take safety measures. Administrative procedures and health management, and protection against secondary risks are also important. Anyone entering the controlled area must wear personal protective glasses and clothing. Regular safety education and safety training are essential. Maintenance management and inspection of laser equipment should be performed systematically.

Eight years have passed since endovenous laser treatment (EVLT) for lower extremity varicose veins became available in Japan in January 2011. In this review, we will focus on the history of EVLT approval and the role of The Japanese Committee for Endovenous Laser Treatment established with EVLT approval.

In endovenous laser ablation, the vein is ablated by exceedingly hot layer of carbonized blood on the fiber tip and direct application of laser energy through the fiber. Both mechanisms coexist in actual clinical ablation. Combination of 1,470 nm laser and radial emitted fiber came into wide use recently. Recent developments are radial emitted slim fibers and a new pull-back device.

Incompetent perforating vein (IPV) is often the cause of varicose veins with skin lesions and recurrent varicose veins. There are various treatments for IPV. We studied percutaneous ablation of perforators (PAPS) using the technique of endovenous laser ablation. The effectiveness of PAPS was measured by ultrasonography to determine the presence of IPV diameter change and reflux, and the symptoms were studied using venous clinical severity score (VCSS). The value of VCSS improved in all cases. All IPV backflow stopped. The IPV diameter is an average of 5.83 ± 1.13 mm preoperatively, 3.43 ± 0.40 mm (p = 0.01) one month after PAPS, and 2.90 ± 0.88 mm (p = 0.03) three months after PAPS (using t test). All IPV diameters were significantly reduced. PAPS has made it possible to provide treatment with simple procedures by device innovation. It is useful as a treatment for varicose veins showing various conditions.

In Japanese guideline for endovenous treatment of varicose vein patients, compression therapy by elastic stockings (ES) are recommended after endovenous laser ablation (EVLA). A few randomized controlled trial (RCT) reported that wearing ES reduced significantly postprocedural pain at 1 week after EVLA, although the level of evidences were weak and the effect of ES on preventing postprocedural deep vein thrombosis (DVT) was unclear. Currently, we suggest that compression therapy by ES is necessary after EVLA. Further RCT in Japan is warranted to clarify whether wearing ES prevent DVT after EVLA.

Recurrent varicose veins are a common problem after endovascular laser ablation (EVLA). The major sources of recurrence after EVLA of the great saphenous vein (GSV) include recanalization and reflux into the tributaries near the junction. Neovascularization is less common after EVLA than high ligation and stripping (HLS). There are few studies investigating long-term outcomes of EVLA for small saphenous vein (SSV) insufficiency. Compared with HLS of the SSV, better short-term results of EVLA of the SSV are shown despite of the higher rate of recurrence possibly related to anatomical variations. Further investigations are needed to confirm long-term results and late recurrence after EVLA of the SSV.