Author/Editor		Drnovšek-Olup, Brigita
Title		Blefaroplastika in odstranitev periokularnih kožnih gub z Er:YAG laserjem nove generacije
Translated title		Blepharoplasty and periocular skin resurfacing with new geneartion Er:YAG laser
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. Suppl 2
Publication year		2002
Volume		str. II-35-8
Language		slo
Abstract		Background. In this study, a new type of Er: YAG laser, emitting irradiation with variable pulse duration, has been used for blepharoplasty and skin resurfacing in periocular region. More than 40 patients have been treated with second generation Er: YAG laser (Fotona Fidelis) for blepharoplasty and skin resurfacing. A focused laser beam (diameter 0.4 mm) with very short pulse with (100 us), that is significantly below the thermal relaxation time of skin, leads to a precise cut with no observable thermal effect on surrounding tissue. The depth of the cut is approximately 1-2 mm, precision comparable to a surgical scalpel. The high repetition rate of consecutive laser pulses (50 Hz at 120 mJ energy) accounts for accumulation of thermal load in tissue, and thus leads to complete hemostasis of the cut tissue. Due to improved cutting abilities of the Er: YAG laser, excision of orbital fat is also performed with one pass of the laser beam. By changing the laser parameters to short pulses (300us), energy 500 mJ, spot diameter 5 mm and repetition rate 12-15 Hz, skin resurfacing was performed. No special pretreatment therapy was used. Anesthesia: 2% Xylocain inj.subcutaneously. Non adhesive dressing for 24 hours was applied after surgery. Epithelisation was complete after ten days. Redness persists up to 5 weeks. Discomfort of patients was mild. Cosmetic results are satisfying. Conclusions. New generation of Er: YAG laser offers a possibility to cut and coagulate the tissue simultaneously, and by changing the parameters to ablate the tissue with heating influence on skin collagen.
Summary		Izhodišča. Prikazati možnosti uporabe novega tipa Er: YAG laserja z variabilnimi laserskimi pulzi za blefaroplastiko in prenovo kože. V zadnjem letu smo opravili blefaroplastiko in periokularno odstranitev kožnih gub z novo generacijo Er:YAG (Fotona Fidelis) pri več kot 40 bolnikih. Fokusiran laserski žarek (diameter 0,4 mm) z zelo kratko pulzno širino (100 us), ki je signifikantno nižja kot termalni relaksacijski čas kože, omogoča natančen rez, brez vidnega toplotnega učinka na okolišnje tkivo. Globina reza je pribl. 1-2 mm, natančnost, ki je primerljiva kirurškemu skalpelu. Visoka frekvenca zaporednih laserskih pulzov (50 Hz pri energiji 120 mJ) pripomore k akumulaciji toplote v tkivu in s tem omogoča hemostazo. Zaradi teh izboljšanih sposobnosti Er: YAG laserja je mogoče rezati in hkrati koagulirati kožo. S spreminjanjem laserskih parametrov na kratek laserski pulz (300 us), energijo 500 mJ, premerom žarka 5 mm in frekvenco 12-15 Hz, pa lahko opravimo odstranjevanje gub. Pred posegom ni potrebna posebna priprava razen preventive z Acyclovirom pri anamnestičnih podatkih za virus Herpesa simplexa. Anestezija je lokalna: 2-odstotni Xylocain inj. subkutano. Po posegu rane prekrijemo z neadhezivnim povojem za 24 ur. Epitelizacija je popolna po 10 dneh, rdečina pa lahko traja tudi do 5 tednov. Bolniki opisujejo bolečine kot znosne. Kozmetični rezultati so dobri. Zaključki. Nova generacija Er: YAG laserja omogoča simultano rezanje in koagulacijo in pri spremembi parametrov ablacijo tkiva in toplotni učinek na kožni kolagen.
Descriptors		BLEPHAROPTOSIS LASER SURGERY TREATMENT OUTCOME