Abstract
Background. The solution to the problem of correction of involutional changes in the periorbital region requires a multidisciplinary approach, as this location can comprise a broad range of problems that need to be addressed. For so many years, laser therapy methods have been the standard for correcting age-related changes. However, many issues concerning combined methods remain open, and the search and development of the most effective protocols for their use is therefore an urgent task of modern medicine.
 Objective. The goal of the study was to develop a combined method to correct involutional skin changes in the periorbital region in young and middle-aged patients using a fractional Nd:YAG and CO2 laser in conjunction with lower transconjunctival blepharoplasty, based on the study of clinical efficacy results and taking into account the indicators of the qualitative characteristics of the skin, as well as microcirculation.
 Material and methods. The study enrolled 108 patients with involutional changes in the skin of the lower eyelid. These patients were classified into groups based on the method of treatment. In the study, relevant methods were used, namely, the study of the qualitative characteristics of the skin (cutometry, TEVA-metry, and corneometry) and microcirculatory processes using laser flowmetry.
 Results. The effectiveness of the developed combined method is based on a substantial positive impact on active and passive hemodynamic mechanisms at all levels of the microvasculature, as demonstrated by an increase of 45.92% in the integral indicator of microcirculation compared to 26.35% and 5.77% in the comparison groups, while the coefficient of variation in the microcirculation indicator increased by 33.02% compared to 24.19% and 6.46% following the use of the method components. The use of the combined treatment method restores the qualitative characteristics of the skin, namely, the moisture index increased by 27% (p 0.05) compared to 14.1% and 7.8% in groups 1 and 2, respectively; the rate of transepidermal water loss decreased by 47% (p 0.05) compared to 35% and 12.7% in groups 1 and 2, respectively; and the elasticity index Ua/Uf increased by 23.2% (p 0.05) compared to 18.4% and 16.4% in groups 1 and 2, respectively.
 Conclusion. Based on the study, it can be concluded that the combined treatment method developed is highly effective.
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