Lower eyelid CO2 laser rejuvenation: A randomized, prospective clinical study1☆,
Section snippets
Methods
The primary outcome of this study was the ability of laser resurfacing of the lower lids, after transconjunctival blepharoplasty, to reduce lower lid wrinkles compared with transconjunctival blepharoplasty alone. Secondary outcomes were the effectiveness of transconjunctival blepharoplasty to reduce lower lid bulging and the importance of timing of the transconjunctival blepharoplasty and resurfacing on the ultimate improvement in lower lid bulging and wrinkles.
Institutional review board
Results
Of the 70 subjects enrolled in the study, 44 followed through to completion. Fifteen dropped out before surgery, and 11 others had inadequate follow-up. Thirteen men and 31 women completed the study, with 20 randomly assigned to the group undergoing simultaneous procedures, and 24 undergoing separate procedures. Three of this latter group opted to undergo transconjunctival blepharoplasty alone and not proceed with laser resurfacing. All subjects were subjectively pleased with their results.
Discussion
During much of the twentieth century, transcutaneous blepharoplasty was the standard approach to lower eyelid fat bulges and wrinkles. Unfortunately, this procedure often leads to complications associated with excessive skin excision and scarring of the middle lamella of the lid, specifically lower lid retraction, ectropion, and lateral canthal rounding.2, 6 Perkins et al2 found lateral canthal rounding in 5% of their series of 300 subjects who underwent subciliary incision blepharoplasty.
The
Historical image
Eyecup, ca 1830–80, Porcelain with Blue Transfer, Spode, England Gift of J. William Rosenthal
As recently as 50 years ago, nearly everyone had at least one eyecup in his or her medicine cabinet. These small cups were used to apply solutions to the eye, and are known as “eyecups,” “eyebaths,” and “eye wash cups.”
∗ Courtesy of the Museum of Vision, Foundation of the American Academy of Ophthalmology.
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Cited by (26)
Interventional and device treatment of the periocular area
2024, Clinics in DermatologyNonsurgical Light and Energy–Based Devices: Utility in Eyelid and Periorbital Surgery
2021, Facial Plastic Surgery Clinics of North AmericaCitation Excerpt :Fully ablative laser resurfacing involves vaporization of the entire epidermis as well as part of the dermis, leading to collagen shrinkage, increased collagen production, and tissue remodeling, resulting in clinical improvement.3,4 These devices are used in conjunction with blepharoplasty but also are shown to be effective for the treatment of periorbital wrinkles when used as monotherapy.4–13 Fully ablative CO2 laser demonstrates consistent efficacy for the treatment of periorbital rhytides with significant clinical improvement.4,7–13
Cosmetic Eyelid and Facial Surgery
2008, Survey of OphthalmologyCitation Excerpt :The skin is closed with a running suture.95 Regardless of the timing of laser treatment, transconjunctival blepharoplasty with adjunctive CO2 laser resurfacing results in improvement of lower eyelid bulging and skin wrinkling.18 Another modification of lower blepharoplasty involves transcutaneous plication of the orbital septum.50
Evolution of eyelid surgery
2005, Facial Plastic Surgery Clinics of North AmericaSafety of laser skin resurfacing in immunocompromised and diabetic patients
2022, European Journal of Plastic Surgery
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Supported in part by That Man May See, Inc, San Francisco, California, and an unrestricted departmental grant from Research to Prevent Blindness, Inc, New York, New York.
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The authors have no commercial interest in any of the products discussed.