Biomedical subjects
Publications and source records attributed to L M David.
Eight patients underwent carbon dioxide (CO2) laser blepharoplasty. The temperature of the upper eyelid conjunctiva was monitored and recorded during laser surgery. A minimal increase in temperature was noted. This study confirms the absence of thermal injury at a distal site from the laser application and the safety of the laser procedure.
Hands are a primary target for actinic damage and premature aging. Until recently, very little could be done to successfully erase the various signs of photoaging. This article presents a simple technique, combining fat transfer and laser resurfacing, to safely and effectively rejuvenate hands and erase the signs of aging.
Previous studies have shown the carbon dioxide (CO2) laser to be effective in the treatment of actinic cheilitis. After CO2 laser abrasion, normal skin and marked cosmetic improvement of the lip were noted. In our study, twenty-three patients were treated with CO2 laser abrasions for cosmetic improvement of facial lines and actinic changes. Pre- and postoperative histopathologic examinations were made on two patients. Preoperative examination of specimens from actinically damaged skin showed atypical keratinocytes in the basal layer of the epidermis, with overlying dense compact orthokeratosis and parakeratosis. Abundant solar elastosis was seen in the papillary dermis. Postoperative histologic specimens showed a normal-appearing epidermis with fibrosis in the papillary dermis and minimal solar elastosis (about four weeks after laser treatment). At present, various modalities are available for the regeneration of the aged skin, including chemical peels and dermabrasion. Significantly fewer complications were noted with CO2 laser abrasion than with these methods. Thus, CO2 laser abrasion can be useful in the cosmetic and medical treatment of the aged skin. Marked clinical and histologic improvement has been demonstrated.
Capillary hemangioma in the infant may result in amblyopia, refractive error, or strabismus, and is often disfiguring. Treatment is challenging with respect to maintaining vision, as well as preserving function of the eyelids and ocular adnexa and obtaining the best possible cosmetic outcome. Neodymium-YAG laser photocoagulation may be a useful modality for the treatment of these lesions. We review the characteristics of the three types of lasers currently in wide use in skin surgery, with particular emphasis on their applicability for treatment of juvenile hemangioma. A possible role for the Nd-YAG laser in the management of these tumors is suggested.
A new technique for upper and lower eyelid blepharoplasty, combining the advantages of the transconjunctival approach with those of the CO2 laser, is described. The use of the CO2 laser as the only cutting tool eliminates many of the most common and the most serious complications of blepharoplasty attributable to hemorrhage and hematoma. The transconjunctival approach yields superior cosmetic results to those of the more commonly performed traditional techniques, which sometimes results in unacceptable lower eyelid scars and/or lower eyelid retraction. Patient rehabilitation to normal activity is rapid because of decreased bruising and swelling. The laser procedure is well suited to the office-based laser surgical practice, but requires a high degree of skill in CO2 laser excisional surgery. In the hands of the inexperienced operator, new and serious complications may occur.
Thirteen patients underwent blepharoplasty in a paired comparison study. A carbon dioxide laser was employed for one side while standard cold steel surgery and electrocautery was used on the contralateral side. In addition to reduced intraoperative time and bleeding, we found less postoperative ecchymosis and edema on the laser-treated side. Long-term follow-up showed no difference between the two sides when cosmetic end result and scars were compared.
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Hemangiomas of the head and neck region can be a therapeutic challenge depending on their size, flow rate, and location. The neodymium-yttrium aluminum garnet (Nd-YAG) laser was used to treat 16 pediatric and adult patients with cavernous, capillary, and mixed hemangiomas as well as hypertrophic port-wine stains of the head and neck. Low-power energy and intermittent short exposure accomplished photocoagulation with minimal damage to surrounding tissue. Follow-up study in these patients has ranged from 1 to 3 years with excellent results in 14 of 16 patients. Few complications and no major morbidity or mortality occurred. Photocoagulation of hemangiomas of the head and neck using the Nd-YAG laser appears to be an exciting new therapeutic option for this difficult problem. Further clinical study and follow-up appear to be warranted.
A new surgical procedure employing a carbon dioxide laser for treating actinic cheilitis is described. Eight patients having biopsy-proven actinic cheilitis and one patient having clinically evident actinic cheilitis but biopsy-proven superficial basal cell carcinoma were treated by vermilion ablation using the carbon dioxide laser. After an average follow-up period of 34 months (27 to 38 months), no patient has had a recurrence of cheilitis. Normal contour of the treated lip has been preserved in all patients, while none has had significant post-treatment scarring.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.