Comparison of the 595 nm long-pulse (1.5 msec) and ultralong-pulse (4 msec) lasers in the treatment of leg veins.

BACKGROUND

Although several lasers and light sources are now available for vascular lesions, treatment of leg veins has not been very satisfactory. Lengthening the pulse width should theoretically result in improved response rates.

OBJECTIVE

This study compared the efficacy and safety of 595 nm pulsed lasers at 1.5 msec and 4 msec in treating leg veins.

METHODS

For group A, 27 healthy adult volunteers with leg veins measuring less than 1 mm in diameter were treated with a 2 mm x 7 mm elliptical handpiece. Each patient had three areas treated. The first two areas were treated with the 4 msec pulsed dye laser with fluences of 16 and 20 J/cm2, while the last area was treated with a 1.5 msec pulsed dye laser at fluences ranging from 14 to 16 J/cm2. For group B, 13 subjects were treated. Areas 1 and 2 were treated with the 4 msec pulsed dye laser using a 3 mm x 5 mm and 5 mm handpiece, respectively, while the third site was treated with a 1.5 msec laser using a 3 mm x 5 mm handpiece. Fluences ranging from 14 to 16 J/cm2 were used. Clinical evaluations were performed and photographs taken at 4-8 week intervals.

RESULTS

Neither laser regularly induced satisfactory diminution or disappearance of these vessels after one treatment. In group A, more than 50% of patients had little to no improvement, while in group B little to no improvement was observed in 33% of patients following a single treatment. Although there was no significant difference in outcomes between the test sites, the 4 msec PDL with a 3 mm x 5 mm spot size appeared to be most effective. Transient hyperpigmentation was common following either treatment, while hypopigmentation was seen in group B subjects. No scarring was noted.

CONCLUSION

Both the 4 and 1.5 msec flashlamp-pumped pulsed dye lasers were ineffective in treating leg telangiectasia following a single treatment.