Laser Treatment Procedures Research Articles

Short pulse grid and subthreshold micropulse laser (the sandwich grid) plus intravitreal ranibizumab for the treatment of diabetic macular edema

ObjectiveTo investigate the effects of two laser treatment procedures combined, short pulse grid laser (SP) and subthreshold micropulse laser (MP) (the sandwich grid [SWG] technique), plus intravitreal ranibizumab (IVR) on central subfield thickness (CSFT), best-corrected visual acuity (BCVA) and macular sensitivity in patients with diabetic macular edema (DME).MethodsForty-five eyes (of 33 patients) with center-involving DME were treated with the SWG laser technique plus IVR and followed for 12 months. Laser treatment was performed at baseline: SP laser spots were placed in a grid pattern in the macular area (500 µm from the fovea) according to the extension of DME; subsequently, MP laser was delivered up to the edge of the fovea. MP laser re-treatment sessions could be performed every 3 months if DME was present and CSFT was ≥ 300 μm on SD-OCT. IVR injection was performed at baseline and repeated monthly if CSFT > 300µm. Preoperatively and monthly, ophthalmological examination was performed including measurements of BCVA, CSFT, and macular sensitivity.ResultsOne-year follow-up data is available for 37 eyes of 27 patients. Mean ± SE CSFT (µm) was 509.36 ± 25.14 and 325.76 ± 15.34 at baseline and 12 months, respectively. A significant reduction in mean CSFT was observed at all study visits compared to baseline (p < 0.001). Mean ± SE BCVA (logMAR) was 0.62 ± 0.04 and 0.45 ± 0.04 at baseline and 12 months, respectively. A significant improvement in mean BCVA was observed at all study visits compared to baseline (p < 0.001). Mean ± SE macular sensitivity (dB) was 17.85 ± 0.80 and improved to 19.05 ± 0.59 after one year of follow-up (p = 0.006). The mean number of IVR injections was 8.29 ± 0.63. The mean number of MP laser procedures including the initial SWG laser session was 3.67 ± 0.22. No ocular or systemic adverse effects were observed.ConclusionThe SWG laser technique plus IVR was associated with significant improvement in macular edema, BCVA, and macular sensitivity in patients with center-involving DME.Clinical Trial Number (CAAE)22969019.4.0000.5440.

Endoluminal treatment for Zenker’s diverticulum – a population-based observational study

Background Zenker’s diverticulum is a false diverticulum arising in the oesophago-pharyngeal junction. It may cause symptoms like dysphagia and regurgitation. In Central Norway, treatment is centralized to St. Olavs hospital, either as an endoscopic stapled oesophago-diverticulostomy procedure at the Department of Gastrointestinal Surgery or as laser diverticulostomy at the Department of Ear, Nose and Throat Surgery, depending on diverticulum size. Methods Retrospective, population-based, study from 2001–2020 on patients treated for Zenker’s diverticulum, at the time with a rigid endoscopic approach. Patients were identified through the in-hospital register for operations. The two treatment groups were compared on relevant pre-, intra-, and postoperative variables by review of the individual patient records. Results 78 consecutive patients, 36 at Dept. of Ear, Nose and Throat Surgery and 42 at Dept. of Gastrointestinal Surgery, were treated with a total of 104 interventions. Crude incidence for a surgery-demanding Zenker’s diverticulum was 0.57 per 100 000 per year. The Dept. of Ear, Nose and Throat Surgery administered significantly less often prophylactic antibiotics than the Dept. of Gastrointestinal Surgery (p < 0.001), administered more frequently intraoperative dexamethasone (p < 0.001), and had significantly more postoperative infections (19.6% vs 3.4%, p = 0.01). No procedure-related mortality was registered. Although no standardized follow-up took place, at a median of 119 months elapsed, observed clinical recurrence was 35% for the endostapler treatment and 51% for the laser treatment procedure. Conclusion Both rigid endoscopic stapled oesophago-diverticulostomy and laser diverticulostomy are safe treatments for Zenker’s diverticulum, however with a substantial risk of recurrence.

Direct and Indirect Roles of Men in Determining Women Decision to Use Laser Procedures for Skin Care.

Laser procedures for skin care is becoming increasingly popular and used by the global community and affect many aspects of human life. However, there is very little research on the role of men in women's decision to follow this dermatological procedure. This study aimed to identify the role of men in motivating women to choose laser-based procedure. A systematic literature review research design was applied in this study. A total of 27 papers were obtained by searching PubMed Central for the 2013-2022 editions. The extraction of samples and the motivation of patients or research respondents in choosing laser procedures for cosmetic treatments were conducted to obtain clues about the role of men in making these decisions. Only six studies explicitly reveal the role of men as motivators of women to perform laser-based dermatological procedures. Four of these six studies were conducted in Asia in countries with a high degree of collectivism. The remaining two studies reveal a minor role for men in women's motivation to choose dermatological procedures. Other studies only indirectly implicate the role of men through intrasexual competition, increased self-esteem, and the needs of the world of work. Limitations of the study lies in the non-specificity of the study sample in the female population, laser-based treatments, and the role of men in motivating women. The role of men in motivating women to perform laser-based skin care procedures is stated explicitly in collectivist cultures while only implicitly in individualist cultures. These findings indicate that the strategy of utilizing the added value of men to laser treatment procedures should be directed at the relationship between men and women in real terms in collective cultured countries.

Optimizing parameters of the Pulsed Dye Laser (PDL, 585-nm) for hemangioma treatment using diffuse reflectance spectroscopy.

The lack of objectivity options for a specific individualized therapy might cause challenges in laser treatment. In other words, we need optimally determined laser parameters for less side effects. Generally, laser treatment procedures seem to be subjective. Then, the final evaluation of the patient needs for optimized better response with less laser sections and less side effects. Therefore, employing a reliable objective technique seems to be essential for better response with less laser treatment sessions and also less side effects. In this research, UV-visible diffused reflection spectra from normal skin and a lesion were taken. We obtained the differences in absorption intensity at 575 nm, the wavelength corresponds to the absorption peak of blood oxyhemoglobin for normal skin and hemangioma. To calibrate the measurements, after using pulsed dye laser (PDL at 585 nm), the PDL treatment response of the patients were graded as "good (>50%), moderate(25%-50%), and poor (0%-25%)," by a specialist. Finally, patients were categorized based on the energy of the laser for the best treatment response to propose the recommended laser parameters. Based on the differences in the absorption peak hemangioma compare with normal skin, the energy density of PDL for a good treatment response of hemangioma was obtained at peak wavelength 575 nm. The analysis of optical reflection spectroscopy can assess the correlation of absorption peak differences of vascular lesions and normal skin. According to this data, it seems to be effective in optimizing lasers parameters for the hemangioma treatment.

VariClose® vein sealing system is inferior to endovenous laser ablation for the treatment of varicose veins

One of the three commercially available cyanoacrylate venous glues used for the treatment of saphenous vein insufficiency is the VariClose® vein sealing system. Previous studies have documented a high rate of occlusion and minimal postoperative complications. The aim of this study was to compare occlusion rates and clinical outcomes of endovenous laser treatment with the VariClose® vein sealing system in the treatment of truncal vein insufficiency. Retrospective non-randomized single center study with prospectively collected data comparing endovenous laser treatment and VariClose® procedures between April 2018 and November 2019. VariClose® was used in 27 patients (30 veins) and endovenous laser treatment in 42 patients (51 veins). The occlusion rate at one, three, and six months were 96%, 85%, and 65% for VariClose® procedures and 100%, 100%, and 97% for endovenous laser treatment procedures (p = 0.01), respectively. Reduction of VCSS scores before treatment and at the last postoperative follow-up visit in the VariClose® group dropped by an average of 1.8 ± 1.6 and in the endovenous laser treatment by an average of 3.3 ± 2.9 (p = 0.01). VariClose® vein sealing system is inferior to endovenous laser treatment as a treatment option for varicose veins as it has a higher recanalization rate.

Short term outcomes of Endoscopic Pilonidal Sinus Laser Treatment: a Single Centre experience.

Short term outcomes of Endoscopic Pilonidal Sinus Laser Treatment: a Single Centre experience. Pilonidal sinus (PS) is a widespread pathologic condition. The etiology of Pilonidal Disease (PD) is in favor of an acquired cause. Multiple surgical options have been advocated. In the last few years a minimally invasive approach to PD has been proposed. We performed a retrospective analysis of short-term surgical outcomes of combining EpSiT approach with the use of a radial laser fiber in the treatment of PD in a Single Centre. At our Proctology Centre, we performed 10 consecutive Endoscopic Pilonidal Sinus Laser Treatment procedures in the period from march 2019 to september 2019. The review of our initial experience suggests that the combination of fistuloscopy and laser ablation in treating fistulizing PD is feasible, safe and reproducible. Pilonidal sinus (PS) is a widespread pathologic condition. The etiology of Pilonidal Disease (PD) is in favor of an acquired cause. Multiple surgical options have been advocated. In the last few years a minimally invasive approach to PD has been proposed. We performed a retrospective analysis of short-term surgical outcomes of combining EpSiT approach with the use of a radial laser fiber in the treatment of PD in a Single Centre. At our Proctology Centre, we performed 10 consecutive Endoscopic Pilonidal Sinus Laser Treatment procedures in the period from march 2019 to september 2019. The review of our initial experience suggests that the combination of fistuloscopy and laser ablation in treating fistulizing PD is feasible, safe and reproducible

New approaches to selective laser trabeculoplasty

Selective laser trabeculoplasty (SLT) is the “golden standard” of laser glaucoma surgery. Its efficacy can be compared to pharmacological therapy, while in some cases its advantages may even lead to a more stable hypotensive effect. SLT may be used as a primary treatment for primary open-angle glaucoma patients and patients with ocular hypertension, while also considered safe and effective in cases when a repeat procedure is required. SLT may potentially decrease the demand for antiglaucoma drugs, improve patient’s response to treatment, make the treatment more comfortable and overall increase the patient’s quality of life. New modifications of standard laser treatment procedures have been emerging lately. This article summarizes scientific data on the efficacy and safety of the new generation of laser trabeculoplasty. It specifies the charateristics of micropulse laser trabeculoplasty (MLT), pattern-scanning trabeculoplasty (PLT) and titaniumsapphire laser trabeculoplasty (TSLT) and recounts the latest research dedicated to them.

Ablative Fractional CO2 Laser for Facial Atrophic Acne Scars.

Ablative fractional carbon dioxide laser resurfacing is a well-established treatment for acne scars. However, there are limited consensus and guidelines regarding the procedure, such as its treatment plan, efficacy, and safety. In this study, we performed a systematic review to assess the efficacy and safety of the fractional carbon dioxide laser treatment procedure, and to provide evidence-based recommendations concerning its practical use on atrophic acne scars. A comprehensive search was performed in, EMBASE, Ovid, Web of Science, and Cochrane databases, using the keywords "scar(s)," "acne vulgaris," "carbon dioxide," and "fraction* laser(s)" for the period from January 1987 to December 2016. The initial literature search identified 337 articles. The final selection included 30 studies: 12 retrospective studies and 18 prospective randomized clinical trials. Ablative fractional carbon dioxide laser is an effective therapy for the treatment of acne scars. The treatment session, interval, and parameters should be customized for each patient. Combination therapy should be considered for ice-pick type acne scars. The use of dermocosmetics in pre- and postoperative care may be beneficial to patients.

Glucose diffusion in colorectal mucosa-a comparative study between normal and cancer tissues.

Colorectal carcinoma is a major health concern worldwide and its high incidence and mortality require accurate screening methods. Following endoscopic examination, polyps must be removed for histopathological characterization. Aiming to contribute to the improvement of current endoscopy methods of colorectal carcinoma screening or even for future development of laser treatment procedures, we studied the diffusion properties of glucose and water in colorectal healthy and pathological mucosa. These parameters characterize the tissue dehydration and the refractive index matching mechanisms of optical clearing (OC). We used ex vivo tissues to measure the collimated transmittance spectra and thickness during treatments with OC solutions containing glucose in different concentrations. These time dependencies allowed for estimating the diffusion time and diffusion coefficient values of glucose and water in both types of tissues. The measured diffusion times for glucose in healthy and pathological mucosa samples were 299.2 ± 4.7 ?? s and 320.6 ± 10.6 ?? s for 40% and 35% glucose concentrations, respectively. Such a difference indicates a slower glucose diffusion in cancer tissues, which originate from their ability to trap far more glucose than healthy tissues. We have also found a higher free water content in cancerous tissue that is estimated as 64.4% instead of 59.4% for healthy mucosa.

Laser Surgeon, Client Education, and Satisfaction with Tattoo Removal.

Studies of satisfaction with tattoo removal outcomes by laser, rated by clients themselves, including qualitative aspects, are sparse. We studied long-term results and client satisfaction with tattoo removal by Q-switched YAG laser. Client satisfaction is influenced by numerous factors: pretreatment expectations, objective observations, pretreatment information, laser treatment procedures, and outcome, including subjective experiences such as pain. Client-surgeon interaction during the full laser treatment course is a major determinant of client satisfaction. The client is in a dynamic state of mind and undergoes a change of opinion during a laser treatment course as a result of his/her experiences. In this continuous process of learning, expectations are changed from a state of high expectation before treatment to a more realistic state with acceptance of outcome. The laser surgeon shall be aware of his/her role as a tutor and prepare the client for a situation, where outcomes can be acceptable albeit not ideal.

Nanoscale deformations in graphene by laser annealing

We investigate a method of inducing nano to micron scale strained regions in graphene using a laser treatment monitored by Raman spectroscopy. The Raman G-peak of the strained region shows a splitting and redshift for graphene exposed to a laser power density above a certain threshold limit (20 mW). We also note blue-shifting of the positions of both Raman D and 2D-peaks and the decrease of both their intensities relative to the G-peak with increasing laser power. These features correspond to p-type doping effects that are believed to be caused by gas adsorbates released from the substrate during the laser treatment. The induced strain is verified by AFM analysis, which shows the blister-like deformations of the treated area and the corresponding strength of the induced gauge fields in the deformed region. We find that, depending on the exact size and geometry of the blisters, the gauge fields can range between 0.4 mT and 300 T. This laser treatment procedure establishes an effective method for the local deformation and doping of graphene, which may be useful for strain engineering in device fabrication.

Muscle relaxation for individuals having tattoos removed through laser treatment: possible effects regarding anxiety and pain.

Effectively managing pain is vital for the well-being and satisfaction of patients undergoing dermatologic treatments involving lasers. This study investigates the potential outcome of using muscle relaxation techniques to reduce pain among people having their tattoos removed with laser treatment. This study consists of 56 participants (mean age 18.1 ± 2.1years) that had tattoos removed using the principle of selective photothermolysis. These participants underwent muscle relaxation before receiving the laser treatment. Their peripheral skin temperatures (PST) were measured both at the beginning and the end of the muscle relaxation period. Then, the Beck Anxiety Inventory was applied to evaluate anxiety levels. Once the laser treatment was completed, pain levels were measured using a visual analogue scale. A total of 125 person-sessions of laser treatment and psychometric assessments were performed in this study. The muscle relaxation method significantly increased the PST of the participants while reducing the levels of anxiety and pain throughout the course of the laser treatment procedure. The PST, anxiety scores, and pain scores all showed significant correlations with one another. According to the results obtained, this study proposes that muscle relaxation techniques be considered possibly auxiliary treatment options for individuals having tattoos removed through laser treatment. Additional studies with a comparison group and a larger sample size are required in the future to confirm the effectiveness of such intervention.

Endovenous laser treatment of the small saphenous vein. Single-centre experience study

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Terlecki P, Przywara S, Iłżecki M, Kawecki P, Zubilewicz T. Original paperEndovenous laser treatment of the small saphenous vein. Single-centre experience study. Phlebological Review. 2014;22(1):6-10. doi:10.5114/pr.2014.46354. APA Terlecki, P., Przywara, S., Iłżecki, M., Kawecki, P., & Zubilewicz, T. (2014). Original paperEndovenous laser treatment of the small saphenous vein. Single-centre experience study. Phlebological Review, 22(1), 6-10. https://doi.org/10.5114/pr.2014.46354 Chicago Terlecki, Piotr, Stanisław Przywara, Marek Iłżecki, Piotr Kawecki, and Tomasz Zubilewicz. 2014. "Original paperEndovenous laser treatment of the small saphenous vein. Single-centre experience study". Phlebological Review 22 (1): 6-10. doi:10.5114/pr.2014.46354. Harvard Terlecki, P., Przywara, S., Iłżecki, M., Kawecki, P., and Zubilewicz, T. (2014). Original paperEndovenous laser treatment of the small saphenous vein. Single-centre experience study. Phlebological Review, 22(1), pp.6-10. https://doi.org/10.5114/pr.2014.46354 MLA Terlecki, Piotr et al. "Original paperEndovenous laser treatment of the small saphenous vein. Single-centre experience study." Phlebological Review, vol. 22, no. 1, 2014, pp. 6-10. doi:10.5114/pr.2014.46354. Vancouver Terlecki P, Przywara S, Iłżecki M, Kawecki P, Zubilewicz T. Original paperEndovenous laser treatment of the small saphenous vein. Single-centre experience study. Phlebological Review. 2014;22(1):6-10. doi:10.5114/pr.2014.46354.

Er:YAG laser treatment in supportive periodontal therapy

To assess clinical and microbiological outcomes of an Er:YAG laser in comparison with sonic debridement in the treatment of persistent periodontal pockets in a prospective randomized controlled multicentre study design. A total of 78 patients in supportive periodontal therapy with two residual pockets were included, 58 were available for the whole follow-up period. Root surfaces were instrumented either with a sonic scaler (Sonicflex(®) 2003 L) or with an Er:YAG laser (KEY Laser(®) 3). Clinical attachment levels (CAL), Probing depths (PD), Plaque control record (PCR) and Bleeding on probing (BOP) were assessed at baseline, 13 and 26 weeks after treatment. In addition, microbiological analysis was performed employing a DNA diagnostic test kit (micro-IDent(®) Plus). Probing depths and CAL were significantly reduced in both groups over time (p < 0.05), without significant differences between the groups (p > 0.05). BOP frequency values decreased significantly within both groups (p < 0.05), with no difference between the laser and the sonic treatment (p > 0.05). PCR frequency values did not change during the observation period (p > 0.05). Microbiological analysis failed to expose any significant difference based on treatment group or period. Employing both sonic and laser treatment procedures during supportive periodontal care, similar clinical and microbiological outcomes can be expected.

Retinal Laser Practice Pattern changes with Induction of New Laser Technology in One Tertiary Eye Care Center in India

Purpose: To assess the change in retina laser practice pattern following induction of new laser technology in India, the pattern scan laser (PASCAL) where the single spot slit lamp delivery mode laser already existed. Materials and methods: The impact of introduction of pattern scan laser (Pascal) on the selection of retina laser device was studied in a prospective study of 273 consecutive patients in a tertiary care eye center in India. Three retina specialists participated in decision-making and one independent observer prospectively recorded the data. The independent observer also used the visual analog scale (VAS) to prospectively record the pain experienced by the patient during pan retinal laser. Results: Two hundred and seventy-three (138 pattern laser and 135 single spot laser) patients received 415 (234 pattern laser and 181 single-spot laser) laser procedures in a study period of 5 months. The number of pan retinal photocoagulation (PRP) in the pattern laser group (162 of 234; 69.23%) was statistically significant (p < 0.0001) than the single-spot laser group (23 of 181; 12.71%). The number of focal laser procedures was statistically significant in the single-spot laser group (98 of 181; 54.14%) than the pattern laser group (34 of 234; 14.53%) (p < 0.0001). PRP pain score was less in the pattern laser group (4.58 ± 1.62) than the single-spot laser group (7.1 ± 0.6) (p = 0.003). There was one adverse event of inferior choroidal detachment in the pattern laser group following one sitting PRP, but it resolved spontaneously. There was no laser treatment-related complications in the single-spot laser group of patients. Conclusion: We observed a quick change to use of pattern scan laser system for PRP procedure but not in the focal and barrage laser treatment procedures. This was possibly due to both physician comfort (speed of each session of treatment and typically one session less in PRP procedure) and patient comfort (one time less physician visit and reduced pain).

Application of ultra-fast laser radiation for processing of biological tissue: mass spectrometry of ablated species

In recent years, due to the demonstrated high accuracy and reproducibility of the surgical procedures with fs pulses, the potential of using fs laser sources as a conventional tool for many surgical applications has increased. Moreover, the laser parameters can be so chosen as to modify the tissue in different ways. Future use of lasers in different fields in medicine will be related with the outcome efficiency of the laser treatment procedures. By studying the process of laser tissue interaction we intend to be able to make qualitative improvements to different type of medical applications of lasers. In this study we examined the ablation process of biological samples (tooth and bone) while varying the laser parameters (pulse duration, wavelength, fluence). The mass spectra of organic molecules at λ = 193 nm and λ = 800 nm were compared. We considered the laser intensity effects on the mass distribution of biological samples. The analysis of the ion species produced by short-pulse laser ablation showed that fs laser ablation is more effective than the ns laser ablation. This article provides a description of our understanding of the process of laser-tissue interaction based on mass spectrometry studies.

Laser-induced thermotherapy (LITT) for malignant liver tumours: the role of sonography in catheter placement and observation of the therapeutic procedure

Evaluation of sonography in the placement of catheters for laser-induced thermotherapy (LITT) as well as for the observation of the therapeutic procedure in cases of malignant liver tumours. Following the placement of 1-4 LITT applicators, 18 patients with malignant liver tumours (recurrence of hepatocellular carcinoma n = 5, metachronous liver metastases n = 13) were examined by ultrasound to determine the position of the applicators as well as the sonographic visualisation of the respective lesion. The laser treatment procedure was also observed sonographically. As standard reference method for the documentation of thermally induced necroses we used magnetic resonance tomography 24-48 hours after the procedure. The tip of the applicator could be localised in all cases, and the position of the applicator relative to the lesion could be directly visualised in 78% of cases. The hyperechogenic thermal effect during LITT had a median size of 4.5 cm, thus proving to be significantly larger than the actual necrosis induced (p < 0.01). The sonographic observation of the procedure identified 8/10 primarily incomplete ablations which were then treated again immediately after correction of the position of the applicators. Continuous sonographic observation of the procedure of LITT can yield important additional information.

The outpatient-procedure effectiveness of laser treatments in oncology.

The outpatient procedure of CO2 laser surgery has been recently integrated into the routine activity of the National Cancer Institute, Milan. Specific operative protocols that are codified for laser outpatient selection after adequate staging by pathology are presented. Specific indications for gynecologic disease (preneoplastic disorders, CIN, VAIN, and VIN), and general-surgery neoplastic disorders (soft tissue sarcomas, lip and oral cavity lesions, breast lesions) are described. Details of the safety procedures, rules of application, laser instrumentation accessories and wattages, both with vaporization and excisional technique, are reported. An overall rate of 30% out of the 4,000 cases treated yearly are selected for laser treatment procedures on the basis of the evaluation of real advantages. The general advantages of laser surgical applications such as reduction of bleeding and postoperative pain, early and late complications; no-touch method; and patient acceptability--have been emphasized in the routine outpatient procedures. Reduction of the total costs and of the waiting list for hospitalization by the new procedures are finally considered.