Abstract
Abstract Purpose: The aim of the study is to histologically compare Er:YAG laser skin resurfacing using ablative, dual‐mode and smooth mode parameters. 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.
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