Mezzana P, Scarinci F, Costantino A, Marabottini N, Valeriani M
G. B. Bietti Eye Foundation, Rome, Italy.
Acta Chir Plast. 2010;52(2-4):35-8.
The authors describe and validate a new technique of one-session, multiple-pass, low spot density, fractional ablative CO2 resurfacing in order to treat lower eyelid skin laxity and photoaging.
The investigation was conducted on 25 patients. The YouLaser CO2 (Quanta System s.p.a., Italy), a 10600-nm CO2 ablative fractional laser system, was used to treat the lower eyelids at a pulse energy of 25 to 35 J, with a pulse duration of 1 ms, 200 microm spot size and a density of 100 laser spots/cm2 for every passage. Each patient had 1 session only, and 1 to 3 passes per area, after application of topical anesthesia. Two blinded physicians assessed eyelid tightening from photographs of 25 patients using a 4-point evaluation scale (1 = 1-25%, 2 = 26-50%, 3 = 51-75%, and 4 = 76-100%. The grades of the 2 evaluating physicians were analyzed using t-test and Kruskal-Wallis analysis of variance. The same evaluation scale was used to assess patient satisfaction in a questionnaire.
The median grades of the 2 physicians for all patients did not differ significantly (p = .88) from one another, and the Kruskal-Wallis assessment (p = 0.0011) indicated unbiased grading among the physicians. All patients achieved a degree of eyelid tightening; 8% achieved 1% to 25% improvement, 24% achieved 25% to 50%, 40% achieved 50% to 75%, and 28% achieved 75% to 100%. Results of patient questionnaires were similar to that of the physicians' evaluation: 4% achieved 1% to 25% improvement, 28% achieved 25% to 50%, 48% achieved 50% to 75%, and 20% achieved 75% to 100%.
The fractioned form of CO2 laser delivery offers very good results with short downtime and easy patient recuperation. The new technique allowed the operator to control skin contraction immediately after laser skin exposure. Using high energy and lower laser spot density permits a control of the amount of contraction simply by the number of passes. Increasing this variable progressively increased skin damage and consequently the contraction.
作者描述并验证一种单次、多次、低光斑密度的分次剥脱性二氧化碳皮肤磨削新技术，用于治疗下睑皮肤松弛和光老化。
对25例患者进行了研究。使用YouLaser CO2（意大利Quanta System s.p.a.公司），一种10600纳米的二氧化碳剥脱性分次激光系统，以25至35焦耳的脉冲能量、1毫秒的脉冲持续时间、200微米的光斑尺寸和每次照射100个激光光斑/平方厘米的密度治疗下睑。每位患者仅进行1次治疗，每个区域照射1至3次，治疗前使用局部麻醉。两名盲法医生使用4分评估量表（1 = 改善1%-25%，2 = 改善26%-50%，3 = 改善51%-75%，4 = 改善76%-100%）根据25例患者的照片评估眼睑紧致度。使用t检验和Kruskal-Wallis方差分析对两位评估医生的评分进行分析。在一份问卷中使用相同的评估量表评估患者满意度。
两位医生对所有患者的中位数评分彼此之间无显著差异（p = 0.88），Kruskal-Wallis评估（p = 0.0011）表明医生之间的评分无偏差。所有患者均实现了一定程度的眼睑紧致；8%的患者改善了1%至25%，24%的患者改善了25%至50%，40%的患者改善了50%至75%，28%的患者改善了75%至100%。患者问卷结果与医生评估结果相似：4%的患者改善了1%至-25%，28%的患者改善了25%至50%，48%的患者改善了50%至75%，20%的患者改善了75%至100%。
分次形式的二氧化碳激光治疗效果良好，停机时间短，患者恢复容易。这种新技术使操作人员在激光照射皮肤后能立即控制皮肤收缩。使用高能量和较低的激光光斑密度，只需通过照射次数就能控制收缩量。逐渐增加这个变量会增加皮肤损伤，从而增加收缩程度。
