Kunzi-Rapp Karin, Dierickx Christine C, Cambier Bernard, Drosner Michael
Institute for Laser Technologies in Medicine and Metrology, University of Ulm, Germany.
Lasers Surg Med. 2006 Dec;38(10):899-907. doi: 10.1002/lsm.20380.
To evaluate the efficacy and safety of a thermal mode Erbium:YAG laser several in-vivo morphological as well as clinical changes were monitored in a multi-center investigation.
STUDY DESIGN/MATERIALS AND METHODS: An Erbium:YAG laser was used at a thermal mode with sub-ablative fluences of 2.1 and 3.1 J/cm(2) with parallel air cooling to treat either periorbital, perioral rhytides or patients with post-traumatic or acne scars. Two treatments were applied 2 months apart, with follow-up at 1, 3, 6, and 12 months post-treatment. Photographs were taken before and at each follow-up visit and evaluated by three blinded independent reviewers. Histology and immunohistochemistry for pro-collagen expression were investigated. Optical coherence tomography (OCT) was performed before, and at 4, 14, and 28 days after single pass treatment with Erbium:YAG thermal pulses.
The improvement of rhytides at 1-3 months follow-up was graded as excellent in 19%, good in 19%, fair in 31%, and no improvement in 31%. At the 6- to 12-month follow-up, the improvement was excellent in 40%, good in 40%, fair in 20%, and no improvement in 0%. The improvement of scars at 3-6 months follow-up was graded as excellent in 50%, good in 25%, fair in 25%, and no improvement in 0%. Intra- and post-operative discomfort was described as mild by the patients. OCT, histological sections and immunohistochemistry demonstrated production of new collagen bundles.
Thermal Erbium:YAG pulses can induce collagen neogenesis, as proved by temperature elevation and morphological changes in the upper dermis. This leads clinically to visible and long lasting reduction of wrinkles and scars after applying multiple passes with minimal side-effects.
为评估热模式铒：钇铝石榴石激光的疗效和安全性，在一项多中心研究中监测了多种体内形态学以及临床变化。
研究设计/材料与方法：使用热模式铒：钇铝石榴石激光，以2.1和3.1 J/cm²的亚消融能量密度，并采用平行风冷，治疗眶周、口周皱纹或创伤后或痤疮瘢痕患者。每隔2个月进行两次治疗，治疗后1、3、6和12个月进行随访。在每次随访前后拍摄照片，并由三名不知情的独立评审员进行评估。研究了组织学和前胶原表达的免疫组织化学。在用铒：钇铝石榴石热脉冲单次治疗前、治疗后4、14和28天进行光学相干断层扫描（OCT）。
在1 - 3个月随访时，皱纹改善情况评为优秀的占19%，良好的占19%，中等的占31%，无改善的占31%。在6至12个月随访时，改善情况评为优秀的占40%，良好的占40%，中等的占20%，无改善的占0%。在3 - 6个月随访时，瘢痕改善情况评为优秀的占50%，良好的占25%，中等的占25%，无改善的占0%。患者描述术中及术后不适为轻度。OCT、组织切片和免疫组织化学显示有新胶原束产生。
热铒：钇铝石榴石脉冲可诱导胶原新生，这通过真皮上层温度升高和形态学变化得到证实。临床上，在多次照射后，这会导致皱纹和瘢痕明显且持久地减少，副作用最小。
