Karsai Syrus, Czarnecka Agnieszka, Jünger Michael, Raulin Christian
Laserklinik Karlsruhe, Kaiserstr. 104, D-76133 Karlsruhe, Germany.
Lasers Surg Med. 2010 Feb;42(2):160-7. doi: 10.1002/lsm.20879.
Ablative fractional lasers were introduced for treating facial rhytides in an attempt to achieve results comparable to traditional ablative resurfacing but with fewer side effects. However, there is conflicting evidence on how well this goal has generally been achieved as well as on the comparative value of fractional CO(2) and Er:YAG lasers. The present study compares these modalities in a randomized controlled double-blind split-face study design.
STUDY DESIGN/MATERIALS AND METHODS: Twenty-eight patients were enrolled and completed the entire study. Patients were randomly assigned to receive a single treatment on each side of the peri-orbital region, one with a fractional CO(2) and one with a fractional Er:YAG laser. The evaluation included the profilometric measurement of wrinkle depth, the Fitzpatrick wrinkle score (both before and 3 months after treatment) as well as the assessment of side effects and patient satisfaction (1, 3, 6 days and 3 months after treatment).
Both modalities showed a roughly equivalent effect. Wrinkle depth and Fitzpatrick score were reduced by approximately 20% and 10%, respectively, with no appreciable difference between lasers. Side effects and discomfort were slightly more pronounced after Er:YAG treatment in the first few days, but in the later course there were more complaints following CO(2) laser treatment. Patient satisfaction was fair and the majority of patients would have undergone the treatment again without a clear preference for either method.
According to the present study, a single ablative fractional treatment session has an appreciable yet limited effect on peri-orbital rhytides. When fractional CO(2) and Er:YAG lasers are used in such a manner that there are comparable post-operative healing periods, comparable cosmetic improvement occurs. Multiple sessions may be required for full effect, which cancels out the proposed advantage of fractional methods, that is, fewer side effects and less down time.
剥脱性分数激光被用于治疗面部皱纹，旨在获得与传统剥脱性皮肤磨削术相当的效果，但副作用更少。然而，关于这一目标总体实现情况以及分数CO₂激光和铒钇铝石榴石（Er:YAG）激光的比较价值，存在相互矛盾的证据。本研究采用随机对照双盲半脸研究设计对这些治疗方式进行比较。
研究设计/材料与方法：招募了28名患者并完成了整个研究。患者被随机分配在眶周区域的每一侧接受单次治疗，一侧使用分数CO₂激光，另一侧使用分数Er:YAG激光。评估包括皱纹深度的轮廓测量、菲茨帕特里克皱纹评分（治疗前和治疗后3个月）以及副作用评估和患者满意度（治疗后1天、3天、6天和3个月）。
两种治疗方式显示出大致相同的效果。皱纹深度和菲茨帕特里克评分分别降低了约20%和10%，两种激光之间没有明显差异。在最初几天，Er:YAG激光治疗后的副作用和不适感略为明显，但在后期，CO₂激光治疗后的抱怨更多。患者满意度一般，大多数患者愿意再次接受治疗，且对两种方法没有明显偏好。
根据本研究，单次剥脱性分数治疗对眶周皱纹有明显但有限的效果。当分数CO₂激光和Er:YAG激光以术后愈合期相当的方式使用时，会出现相当的美容改善效果。可能需要多次治疗才能达到完全效果，这抵消了分数治疗方法所宣称的优势，即副作用更少和停机时间更短。
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