Periocular Er:YAG laser skin resurfacing in ablative, dual mode and smooth mode – a histological comparison
Beltram, M. & Drnovsek-Olup, B.
Acta Ophthalmologica Scandinavica, 85, p.0. 2007.
Purpose:
The aim of the study is to histologically compare Er:YAG laser skin resurfacing using ablative, dual-mode and smooth mode parameters.
Materials and Methods:
30 patients with blepharochalasis were treated with a 2940 nm Er:YAG laser (Fidelis by Fotona) at day 0, 7 and 21 before elective blepharoplasty. At time of surgery the irradiated lid tissue has been removed and prepared for histological analysis. The laser settings used in the ablative mode were: fluence 2.5 – 4.5 J/cm2, spot size 5 mm, repetition rate 5 – 8 Hz, pulse length 300 μs; dual mode: first pass as in ablative mode, then second pass with fluence 0.5 – 1.5 J/cm2, spot size 5mm, repetition rate 12 – 15 Hz, pulse length 300 μs and 60% overlapping; smooth mode: fluence 0.75 – 2.00 J/cm2, spot size 5 mm, repetition rate 20 Hz, pulse length 550 μs, no overlapping.
Results:
We observed deep collagen denaturation at fluences above 1.25 J/cm2 and total epidermal damage at fluences above 1.75 J/cm2; complete regeneration of epidermis at day 7 and collagen remodeling up to 240 μm deep at day 21 after smooth mode laser treatment. These changes were statistically significantly different compared to changes after ablative and dual-mode treatment.
Conclusions:
Smooth mode Er:YAG laser skin resurfacing is a safe and effective method producing new collagen synthesis and remodeling, with less epidermal damage compared to ablative and dual-mode resurfacing.