Lower Eyelid Synechia: A Complication of Periorbital CO2 Laser Resurfacing

Abstract

Introduction: Laser resurfacing of the lower eyelids is a popular option for rejuvenation. Lower eyelid synechia (adhesions) can occur with laser skin resurfacing, but literature searches for this topic failed to show any dedicated articles addressing this complication. Materials and Methods: The author routinely performs more than 120 procedures per year involving high-fluence, high-density, multipass CO2 laser skin resurfacing to the lower eyelids (which includes full-face and periorbital treatment combined). This article discusses the author's clinical experience dealing with lower eyelid synechiae. Health Insurance Portability and accountability Act guidelines as well as the World Medical Association Declaration of Helsinki regarding ethical principles for medical research were followed. Results: Lower eyelid synechiae are an uncommon complication in the reepithelialization phase of laser resurfacing. If recognized and treated early, permanent tissue adhesion is rare; if allowed to totally reepithelialize; however, permanent deformity may occur. Conclusion: Laser resurfacing remains a popular option for rhytid effacement, skin tightening, and dyschromia improvement of the lower eyelids whether performed as an isolated procedure or as part of full-face laser resurfacing. Lower eyelid synechiae are an uncommon but potential complication that can lead to permanent disfigurement if not diagnosed and treated early in the healing period after laser treatment. All physicians and staff that perform laser resurfacing should be familiar with the early diagnosis and early treatment of lower eyelid synechiae.