Neodymium-doped Yttrium Aluminum Garnet Laser Research Articles

Laser therapy for treating hypertrophic and keloid scars.

Laser therapy for treating hypertrophic and keloid scars.

Integration of Decay Time Analysis and Radiation Measurement for Quantum-Dot-Based Scintillator’s Characterization

In this study, we demonstrated the process of an integrated apparatus for decay time analysis and gamma radiation measurement with a liquid-scintillator-based cadmium-doped zinc oxide (CZO) nanomaterial. Generally, time-resolved photon counting is an essential analysis method in the field of precision measurement in the quantum domain. Such photon counting equipment requires a pulse laser that can be repeated quickly while having a sharp pulse width of picoseconds or femtoseconds as a light source. Time-correlated single photon counting (TCSPC) equipment, which is currently a commercial product, is inconvenient for recent development research because the scintillator size and shape are limited. Here, neodymium-doped yttrium aluminum garnet (Nd/YAG) laser TCSPC equipment was constructed to analyze the fluorescence characteristics of scintillators having various sizes and shapes. Then, a liquid scintillator added with CZO nanomaterial was prepared and the Nd/YAG laser TCSPC equipment test was performed. As a result of measuring the scintillator using the manufactured Nd/YAG laser TCSPC equipment, the non-CZO liquid scintillator was analyzed at 2.30 ns and the liquid scintillator equipped with CZO-loaded nanomaterial was analyzed at 11.95 ns. It showed an error within 5% when compared with the result of commercial TCSPC equipment. In addition, it was verified that the Nd/YAG laser TCSPC system can sufficiently measure the decay time in nanoseconds (ns). Moreover, it was presented that the Compton edge energy of Cs−137 is 477.3 keV, which hardly generates a photoelectric effect, and Compton scattering mainly occurs.

Laser-induced plasma irradiation driven rapid photocatalytic degradation of methylene blue with TiO2 nanoparticles

A light source from a neodymium-doped yttrium aluminium garnet laser (1064 nm) was used to excite the A3 iron plate to produce plasma and release UV light for the rapid photocatalytic degradation of methylene blue (MB) dye. The 30 nm anatase TiO2 nanoparticles were used as the photocatalysts. Plasma effectively degrades organic matter under optimal conditions: (10 mg/L MB, 2 g/L TiO2, 50 ml/L H2O2, pH = 10, and P = 70 mW); the degradation efficiency is related to the UV light source (200 nm - 400 nm) produced by plasma sonoluminescence. The effect of the initial dye concentration, catalyst dosage, laser energy, and pH value, on the degradation of dyes was studied using UV–vis spectrophotometry. Ion chromatography confirmed the mineralisation of methylene blue (MB). The results showed that laser-induced plasma (LIP) photocatalysis effectively degrades MB.

Fractional Q-Switched 1064 nm Laser for Treatment of Atrophic Scars in Asian Skin.

Background and Objectives: Asian patients with Fitzpatrick skin type III–IV are a less studied subtype of patients in the medical literature. Q-Switched, 1064 nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser with a fractionated beam profile (QSF) is a new modality that was reported to be effective in the treatment of scars. This study aims to evaluate the efficacy and safety of QSF Nd: YAG laser in treating scars in Asian patients. Materials and Methods: A total of 29 Subjects were treated with 1064 nm QSF laser. Each patients had three treatments with a fractionated microlens array handpiece every 8 weeks). Efficacy of treatment was evaluated using the Goodman and Baron’s quantitative grading scale before and 3 months after the last treatment. Results: All 29 patients treated had significant improvement of acne scars according to Goodman and Baron’s Quantitative Global Acne Scarring Grading System. No side effect has been observed except some minor erythematous reactions in three patients. Conclusions: Our results confirm that the 1064 nm QSF Nd: YAG laser is a safe and effective technique for treating scars in Asians.

Longitudinal Evaluation of an Acute Nd:YAG Laser-Induced Macular Hole: A Case Report

Macular Holes (MHs) caused by neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers are increasingly reported worldwide, but there is little experience with their management. Furthermore, longitudinal evaluations of their characteristics are scarce. Here, we describe the ophthalmologic findings and follow-up of a patient with an accidental Nd:YAG laser-induced MH. The patient attended with central scotoma of the right eye

A Fluid-filled Pocket of Descemet Membrane Detachment

A 5-year-old child presented with complaint of whitish discoloration in the right eye (OD), with visual acuity 20/200 OD. Ocular history was significant for blunt trauma OD 2 years ago. Slit-lamp examination revealed central, bullous Descemet membrane detachment (DMD) OD, with accumulation of turbid fluid resembling a hypopyon (Fig A-B), confirmed on anterior-segment OCT (Fig C). Ocular examination of the left eye was unremarkable. After a failed trial of neodymium-doped yttrium aluminium garnet (Nd:YAG) laser descemetotomy OD, the fluid was successfully aspirated surgically using a 26-G needle with descemetopexy using 14% isoexpansile perfluoropropane.

Academy IRIS® Registry Analysis of Incidence of Laser Capsulotomy Due to Posterior Capsule Opacification After Intraocular Lens Implantation.

PurposeAcademy IRIS® (Intelligent Research in Sight) Registry was used to determine the incidence of postoperative neodymium-doped yttrium aluminum garnet laser capsulotomy (Nd:YAG) and time to posterior capsular opacification (PCO) diagnosis based on intraocular lens (IOL) type and brand.MethodsThis retrospective analysis included eyes implanted with 1 of 2 IOL brands, with ≥365 days of follow-up available in the IRIS Registry, and ≥2 visits within 180 days of surgery. Analyses included Nd:YAG incidence due to PCO within 1 year after surgery by IOL type and brand, mean time to PCO diagnosis, and mean time to Nd:YAG.ResultsOf 89,947 eyes after cataract surgery, 24,834 (28%) had PCO diagnosis within 365 days, and 9262 (10%) underwent Nd:YAG; 4.1% of 57,523 eyes with monofocal and 21.2% of 32,424 eyes with diffractive multifocal (MF) or diffractive extended depth of focus (EDOF) IOLs had Nd:YAG. Nd:YAG was 3.2 times more likely in eyes with diffractive MF or diffractive EDOF IOLs versus monofocal. For monofocal IOLs, 3.2% of eyes with AcrySof® and 8.1% of eyes with Tecnis® had Nd:YAG (P<0.0001). For diffractive MF or diffractive EDOF IOLs, 13.0% of eyes with AcrySof and 21.7% of eyes with Tecnis had Nd:YAG (P<0.0001). Nd:YAG risk was 2.4 times higher in eyes with Tecnis versus AcrySof IOLs. Overall, mean time to PCO diagnosis and Nd:YAG was 150.7 and 180.7 days. Mean time to PCO for monofocal versus diffractive MF or diffractive EDOF IOLs was 165.3 versus 139.7 days (P<0.0001). Mean time to Nd:YAG for monofocal versus diffractive MF or diffractive EDOF IOLs was 196.4 versus 175.3 days (P<0.05).ConclusionReal-world data for AcrySof and Tecnis IOLs revealed lower Nd:YAG rates and longer time to PCO diagnosis and Nd:YAG after monofocal versus diffractive multifocal or diffractive EDOF implantation. Nd:YAG rates were significantly lower with AcrySof versus Tecnis IOLs.

Compositional analysis of soil using calibration-free laser-induced breakdown spectroscopy

Compositional analysis often soil samples collected from Islamabad, Pakistan, is performed using the fundamental harmonic (1064 nm) of a Q-switched Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser. The plasma emissions were recorded using a broadband (200–800 nm) spectrometer (LIBS2500plus, Ocean Optics Inc., USA) having resolution. The qualitative analysis of the pelletized soil samples confirms the presence of several heavy metals (Titanium, Vanadium, Chromium, Manganese, Iron, Cobalt, Nickel, Lead, Copper, Zinc, Cadmium, Zirconium, Cesium, Strontium, and Barium), light and nutrients elements (Lithium, Rubidium, Aluminum, Boron, Carbon, Potassium, Nitrogen, Magnesium, Phosphorus, Silicon, and Calcium). The quantitative analyses were performed using the calibration-free laser-induced breakdown spectroscopy, its variant, and single sample calibration techniques. It is found that the concentration of heavy metals (Cadmium, Cobalt, Chromium, and Nickel) exceeds the maximum permissible limit, which is eventually accumulated in the human body through the food chain and threatens health.

Laser tattoo removal: laser principles and an updated guide for clinicians.

Tattoos have become ingrained in our society and have served varied purposes throughout human civilization. So long as tattoos have existed, there has been demand for their removal. Lasers are currently the modality of choice in the removal of tattoos, as they are more efficacious than previously used methods. The most common lasers are the 532nm and 1064nm neodymium-doped yttrium aluminum garnet lasers, the quality-switched 694nm Ruby laser, and the quality-switched 755nm alexandrite laser. However, picosecond lasers are rapidly gaining favor in tattoo removal. An in-depth understanding of laser principles and how they can be applied in the setting of tattoo removal is key. Also, a greater understanding of the origin of and colors within a tattoo, the presence of tattoo layering, and a patient's Fitzpatrick skin type increase the odds of satisfactory results. This review provides dermatologists with a comprehensive summary on laser fundamentals, an overview on treatment principles, and recent developments in the field of laser tattoo removal.

Republication de : Efficacy of photobiomodulation in the management of tinnitus: A systematic review of randomized control trials

There is a controversy in regards to the efficacy of photobiomodulation (PBM) in the management of tinnitus. The aim was to systematically review randomized controlled trials (RCTs) that assessed the efficacy of PBM (low-level laser therapy) in the management of tinnitus. The focused question was “Is PBM effective in the management of tinnitus?”. Indexed databases were searched up to and including June 2020 using different combinations of the following key words: (a) laser; (b) diode; (c) low-level laser therapy; (d) photobiomodulation; (e) tinnitus; (f) medium-level laser; (g) photo-biomodulation; and (h) low-power laser; and RCTs performed on humans were included. Letters to the editor; case reports/series; commentaries; experimental studies and historic reviews were excluded. The risk of bias was assessed using the modified cochrane collaboration tool. The format of the current systematic review was personalized to summarize the appropriate information. Ten RCTs (2 single-blinded and 8 double-blinded) were included. One study reported 30% and 100% resolution of tinnitus using diode and Neodymium-doped Yttrium Aluminum Garnet lasers; respectively. One study reported that PBM was effective in relieving tinnitus for up to 3 months. Eight studies reported that PBM was ineffective in the management of chronic tinnitus. The risk of bias was high; medium and low in 4; 5 and 1 studies; respectively. The effectiveness of PBM in the management of tinnitus remains debatable. Further power-adjusted and well-designed RCTs with long-term follow-up are needed.

Evaluation of the efficacy and safety of the 1064 nm picosecond Nd:YAG laser with a topically applied gold and diamond suspension for facial skin rejuvenation: A pilot study.

To investigate the efficacy and safety of combined treatment with a serum comprising a micro-diamond suspension and micro-gold cage with a 1064 nm picosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for facial skin rejuvenation. Topical serum was applied to the entire face and allowed to penetrate the skin and hair follicles for 20 min. Each participant was then treated with a 1064 nm picosecond Nd:YAG laser on the face. Photographs of each participant were taken at baseline, immediately after treatment, and 2 weeks after treatment using an imaging tool (Mark-Vu®; PSI PLUS, Suwon, Republic of Korea). Global improvement scores by two blinded investigators and participants' satisfaction scores were also assessed. The melanin index (MI), transepidermal water loss (TEWL), and skin hydration were evaluated using a device. Parameters associated with skin rejuvenation were assessed using Mark-Vu®. Adverse events were observed and reported by participants and physicians during the treatment and follow-up visit. At week 2, 40% (4/10) of the participants showed more than moderate clinical improvement in the investigator's global improvement assessment. No significant differences were observed in the MI, TEWL, skin hydration level, or skin parameters of Mark-Vu®. At week 2, 40% of the participants reported a high satisfaction score and minimal side effects. The novel topical facial serum comprising micro-diamond suspension and micro-gold cage is safe and effective when combined with laser treatment for facial rejuvenation.

Laser-Assisted Nanotexturing and Silver Immobilization on Titanium Implant Surfaces to Enhance Bone Cell Mineralization and Antimicrobial Properties.

Despite the great advancement and wide use of titanium (Ti) and Ti-based alloys in different orthopedic implants, device-related infections remain the major complication in modern orthopedic and trauma surgery. Most of these infections are often caused by both poor antibacterial and osteoinductive properties of the implant surface. Here, we have demonstrated a facile two-step laser nanotexturing and immobilization of silver onto the titanium implants to improve both cellular integration and antibacterial properties of Ti surfaces. The required threshold laser processing power for effective nanotexturing and osseointegration was systematically determined by the level of osteoblast cells mineralized on the laser nanotextured Ti (LN-Ti) surfaces using a neodymium-doped yttrium aluminum garnet laser (Nd:YAG, wavelength of 1.06 μm). Laser processing powers above 24 W resulted in the formation of hierarchical nanoporous structures (average pore 190 nm) on the Ti surface with a 2.5-fold increase in osseointegration as compared to the pristine Ti surface. Immobilization of silver nanoparticles onto the LN-Ti surface was conducted by dip coating in an aqueous silver ionic solution and subsequently converted to silver nanoparticles (AgNPs) by using a low power laser-assisted photocatalytic reduction process. Structural and surface morphology analysis via XRD and SEM revealed a uniform distribution of Ag and the formation of an AgTi-alloy interface on the Ti surface. The antibacterial efficacy of the LN-Ti with laser immobilized silver (LN-Ti/LI-Ag) was tested against both Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria. The LN-Ti/LI-Ag surface was observed to have efficient and stable antimicrobial properties for over 6 days. In addition, it was found that the LN-Ti/LI-Ag maintained a cytocompatibility and bone cell mineralization property similar to the LN-Ti surface. The differential toxicity of the LN-Ti/LI-Ag between bacterial and cellular species qualifies this approach as a promising candidate for novel rapid surface modification of biomedical metal implants.

Clinical Efficacy of Iris Cystostomy Using a Yttrium Aluminum Garnet Laser

Purpose: To report the clinical efficacy of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser iris cystotomy in iris cysts.Methods: We examined three eyes with primary iris cysts diagnosed by ultrasound biomicroscopy that had fewer cornea endothelial cells or reduced visual acuity due to an occluded visual axis. Nd:YAG laser cystotomy was done. The logarithm of the minimum angle of resolution (logMAR) visual acuity, intraocular pressure (IOP), and specular microscopy test at baseline and last follow-up were reviewed.Results: The average patient age was 54.0 ± 5.3 years; the mean follow-up was 11.7 ± 2.1 months. The baseline and final logMAR visual acuity were 0.23 ± 0.25 and 0.16 ± 0.15, respectively. Visual acuity improved, although not significantly (p = 0.317). The baseline and final IOP were 14.7 ± 2.3 and 13.7 ± 0.6 mmHg, respectively (p = 0.276). The corneal endothelial cell density (p = 0.109), hexagonality (p &gt; 0.999), and coefficient of variation (p = 0.285) were not significantly different after treatment. There were no serious complications or recurrence.Conclusions: After Nd:YAG laser cystotomy, the cell density and morphology of corneal endothelial cells changed little. It can be considered an effective treatment when there is a decrease in corneal endothelial cells or occlusion of the visual axis.

Molecular Emissions from Stretched Excitation Pulse in Nanosecond Phase-Selective Laser-Induced Breakdown Spectroscopy of TiO2 Nanoaerosols.

In phase-selective laser-induced breakdown spectroscopy (PS-LIBS), gas-borne nanoparticles are irradiated with laser pulses (∼2.4GW/cm2) resulting in breakdown of the nanoparticle phase but not the surrounding gas phase. In this work, the effect of excitation laser-pulse duration and energy on the intensity and duration of TiO2-nanoparticle PS-LIBS emission signal is investigated. Laser pulses from a frequency-doubled neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (532nm) are stretched from 8ns (full width at half maximum, FWHM) up to ∼30ns at fixed pulse energy using combinations of two optical cavities. The intensity of the titanium atomic emissions at around 500nm wavelength increases by ∼60%, with the stretched pulse and emissions at around 482nm, attributed to TiO, enhanced over 10 times. While the atomic emissions rise with the stretched laser pulse and decay around 20ns after the end of the laser pulse, the TiO emissions reach their peak intensity at about 20ns later and last longer. At low laser energy (i.e., 1mJ/pulse, or 80MW/cm2), the TiO emissions dominate, but their increase with laser energy is lower compared to the atomic emissions. The origin of the 482nm emission is explored by examining several different aerosol setups, including Ti-O, Ti-N, and Ti-O-N from a spark particle generator and Ti-O-N-C-H aerosol from flame synthesis. The 482nm emissions are attributed to electronically excited TiO, likely resulting from the reaction of excited titanium atoms with surrounding oxidizing (carbonaceous and/or radical) species. The effects of pulse length are attributed to the shift of absorption from the initial interaction with the particle to the prolonged interaction with the plasma through inverse bremsstrahlung.

Antimicrobial efficacy and topographical alterations of photodynamic therapy versus conventional antimicrobials on contaminated zirconia ceramic in vitro

PurposeThe aim of this in vitro study was to assess the efficacy of antimicrobial photodynamic therapy (aPDT), neodymium-doped yttrium aluminium garnet (Nd:YAG) laser, and two other disinfecting agents against P. gingivalis and T. forsythia that colonized over zirconia ceramics and to evaluate if the disinfecting protocols result in zirconia surface alteration. Materials and methodsThe experiment was conducted on pre-sintered, commercially available Yttria Stabilized Zirconia (Y-TZP) ceramic blocks. The bacterial strains of P. gingivalis and T. forsythia were used to contaminate the zirconia specimens. The infected zirconia specimens were randomly divided into 4 groups (n=20/group): aPDT, Nd:YAG laser, hydrogen peroxide (H2O2), and chlorhexidine groups. The viability of bacteria was assayed using the MTT protocol. The surface roughness (Ra) of all zirconia specimens was estimated using a profilometer and a drop-shape analyzer was used to evaluate the contact angle using a special sessile drop method. ResultsA statistically significant reduction by the aPDT group is noticed for P. gingivalis and T. forsythia species compared to other disinfection methods (p<0.05). The second highest reduction was seen for chlorhexidine followed by Nd:YAG laser. The least reduction was demonstrated for the hydrogen peroxide group. Statistically, there was no significant difference in Ra scores between the four groups. However, the contact angles were significantly reduced from the zirconia specimens after the aPDT method which indicates a hydrophilicity increase compared to other groups. The SFE scores of all decontamination protocols from highest to lowest were aPDT (41.68), chlorhexidine (39.83), Nd:YAG (34.52), and H2O2 (29.88). ConclusionsAntimicrobial photodynamic therapy demonstrated a high antibacterial efficacy over zirconia ceramic surface without altering surface topography.

Clinical Study of a Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser with Different Parameters in the Treatment of Chloasma: A Randomized-Controlled Trial.

Objective: To explore the clinical efficacy of a Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with different parameters in the treatment of chloasma. Methods: In this study, 30 patients with chloasma, symmetrically distributed on the left and right sides of the face and who were treated with a Fayton Q-switched 1064 nm Nd:YAG laser, were recruited. The patients were randomly selected for the treatment of facial lesions on the left and right sides of the face using a spot diameter of 9 mm and an energy density of 0.8 J/cm2 on one side, and, on the opposite side, a spot diameter of 6 mm with an energy density of 1.2 J/cm2. The laser frequency was 5 Hz and treatment was conducted once every 7-10 days and repeated eight times as a course of treatment. At the end of the course of treatment, as well as 1, 3, and 6 months after treatment, front-facing images and 45° left- and right-side images were taken, respectively. The curative effect of the treatment was evaluated using the Melasma Area Severity Index (MASI) score. Results: The results of this study showed that the total effective rate of a Fayton Q-switched 1064 nm Nd:YAG laser in the treatment of chloasma was 60%. Conclusions: Using a Q-switched 1064 nm Nd:YAG laser represents a safe and effective approach for the treatment of chloasma. The therapeutic effects of the parameter sets, that is, a spot diameter of 9 mm and an energy density of 0.8 J/cm2, and a spot diameter of 6 mm with an energy density of 1.2 J/cm2, were similar. The treatment time and average effective times of the latter were relatively shortened. Clinical Trial Registration number researchregistry6799.

Costs and Healthcare Resource Utilization Associated with Posterior Capsule Opacification After Cataract Surgery with Five Different Intraocular Lenses: An Economic Analysis for Spain

PurposeTo estimate the economic impact of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy and its related complications for five different intraocular lenses (IOLs) from the payer and hospital perspectives in Spain.Materials and MethodsThe three-year incidence rates of Nd:YAG laser capsulotomy after cataract surgery with five different single-piece acrylic monofocal IOLs (AcrySof IOLs, AJL LLASY60, IOL Tech Stabibag, Medicontur Bi-flex, Zeiss Asphina) for 8293 patients were derived from odds ratios of multivariate analysis adjusted for age, gender, and diabetic retinopathy. A cost-consequence model for a hypothetical cohort of 2000 eyes was then developed to quantify the potential impact of Nd:YAG capsulotomy in terms of costs and time for each of the included IOLs, from the payer and hospital perspectives.ResultsThe adjusted three-year Nd:YAG laser capsulotomy incidence was 5.0% (95% CI 3.9 to 6.1) for AcrySof and ranged from 26.0% to 44.0% for the other four IOLs. The average costs of Nd:YAG treatment and related complications were €261.90 for payers and €19.99 for hospitals. The average time needed for Nd:YAG treatment and related complications was 32.82 minutes. Model estimates based on 2000 hypothetical cataract surgeries showed that AcrySof IOLs could lead to cost savings between €110,259.90 and €205,591.50 for payers. For hospitals, time, and cost savings with AcrySof ranged from 230.29 hours and €8415.79 compared to Zeiss Asphina to 429.40 hours and €15,692.15 compared to AJL LLASY60 IOLs.ConclusionPost cataract surgery, AcrySof IOLs were associated with a significantly lower incidence of Nd:YAG treatment and its subsequent complications compared to other IOLs. Our analysis shows that IOL choice is an important factor that can reduce the burden for patients, payers, and hospitals.

Ablative effect of the interstitial laser setting in the human placental model.

To assess the impact of laser power and time on interstitial ablation generated by neodymium-doped yttrium aluminium garnet (Nd:YAG) and diode laser in the human placental model. The experiment was carried out in a simulation model of interstitial laser ablation on ex-vivo placental tissue. One-hundred and forty-four pieces of fresh placentae were interstitially ablated with Nd:YAG or diode laser at various power (15, 20, 25, 30 W)-time (5, 10, 15 s) combinations. The ablation tissues were evaluated using both sonographic and histopathologic measurements. Laser generator, power, and time significantly affected the ablation size (p < 0.001). The coagulation zone continuously increased with extending time at the power of 15, 20, and 25 W. When adjusting to the power of 30 W, increased time from 10to 15 s did not induce the larger coagulation diameter. The maximal diameter was obtained at the laser power of 20 W for 15 s. The ablation from the diode laser was greater than that from Nd:YAG laser. The sonographic evaluation overestimated the ablation size by an average of 24%. Diode laser destroys greater tissue than Nd:YAG laser. Different power settings of interstitial laser ablation produce diverse patterns of correlation between laser time and coagulation size.

Efficacy of the Neodymium-Doped Yttrium Aluminum Garnet Laser in the Treatment of Keloid and Hypertrophic Scars: A Systematic Review and Meta-analysis.

Keloid and hypertrophic scars are the most common types of pathological scars. They can cause itching, pain, erythema, and psychological stress due to cosmetic problems, decreasing the quality of life for affected individuals. The neodymium-doped yttrium aluminum garnet (Nd:YAG) multipurpose laser is used to treat pathological scars, and studies have shown that the Nd:YAG laser can markedly improve scarring. We performed a meta-analysis to evaluate the efficacy of the Nd:YAG laser in the treatment of keloid and hypertrophic scars. A literature search of PubMed, Web of Science, Scopus, Cochrane, Embase, CNKI, and Wanfang was performed between January 1st, 2010, and July 14th, 2021. The Vancouver Scar Scale (VSS) was used to evaluate treatment outcomes. We used the R version 4.0.0 software for statistical analysis. The Nd:YAG laser improved the condition of keloid and hypertrophic scars and reduced VSS score (mean difference [MD]: 2.96, 95% confidence interval [CI]: 2.08-3.84, p &lt; 0.01). There was no obvious difference in the results between regions. A subgroup analysis by scar type revealed that the curative effect of the Nd:YAG laser on keloid scars (MD: 2.02, 95% CI: 0.58-4.63, p = 0.10) was less marked compared with that on hypertrophic scars (MD: 3.05, 95% CI: 1.58-4.52, p &lt; 0.01). With the combined use of the Nd:YAG laser and other treatment methods, a more significant change in VSS score was noted (MD: 4.28, 95% CI: 2.07-6.49). This meta-analysis showed that the Nd:YAG laser can improve the condition of keloid and hypertrophic scars and effectively reduce VSS score. Moreover, the curative effect of this approach on keloid scars is less marked compared with that on hypertrophic scars. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Diagnostic imaging techniques in patient with liquefied aftercataract imitating intraocular lens opacification

An 81-year-old patient was referred for an intraocular lens (IOL) exchange surgery because of a presumed IOL opacification. Using diagnostic imaging techniques such as anterior segment optical coherence tomography (OCT) and Scheimpflug imaging, we revealed that the presumed IOL opacification was in fact a liquefied aftercataract. As a result, an intraocular surgery was avoided and the patient was successfully treated with a neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy.