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Patient Satisfaction and Management of Postoperative Complications Following Ablative Carbon Dioxide Laser Resurfacing of the Lower Eyelids.

Publication ,  Journal Article
Kim, JS; Ginter, A; Ranjit-Reeves, R; Woodward, JA
Published in: Ophthalmic Plast Reconstr Surg
September 2021

PURPOSE: To describe postoperative management following ablative carbon dioxide laser resurfacing of the lower eyelids. METHODS: A retrospective review of patients who consecutively underwent bilateral lower eyelid ablative carbon dioxide laser resurfacing by a single experienced oculoplastic surgeon over a 6-year period was conducted. Patient satisfaction, aesthetic outcomes, and postoperative complications were evaluated as adjunctive or monotherapy. RESULTS: Among 424 patients included in the study, most were female (n = 356, 84.0%) and Caucasian (n = 404, 95.3%), with Fitzpatrick skin types II-III (n = 381, 89.9%). Mean age was 62.8 years (standard deviation: 9.7 years). Most (n = 324, 76.4%) underwent fractional ablative carbon dioxide laser resurfacing of the lower eyelids, whereas 91 (21.5%) received traditional laser resurfacing and 9 (2.1%) had both fractional and traditional laser resurfacing during the same session. At the time of lower eyelid laser resurfacing, most patients also underwent concurrent procedures, including upper (n = 321, 75.7%) and lower blepharoplasty (n = 348, 82.1%); a small proportion of patients (n = 39, 9.2%) did not undergo any concurrent surgical procedure. In addition to ablative laser resurfacing of the lower eyelids, 25 (5.9%) had upper eyelid laser resurfacing, 60 (14.2%) had full-face laser resurfacing, 55 (13.0%) had neck laser resurfacing, and 42 (9.9%) had additional treatment of solar lentigines or dyschromias on the face. Median follow-up duration was 3.9 months (interquartile range: 2.0-11.0 months). In the immediate postoperative period, 22 patients (5.2%) developed contact dermatitis from topical antibiotic eye drops and/or ointment prescribed postblepharoplasty. Postinflammatory hyperpigmentation was observed in 40 patients (9.4%) despite topical prophylaxis; all were eventually successfully treated with a combination of topical nonprescription and prescription creams and/or oral tranexamic acid. A localized herpetic outbreak occurred in 3 (0.7%) who underwent full-face laser resurfacing and 1 (0.2%) who underwent periocular laser resurfacing only; all were successfully treated with oral antiviral therapy. Two (0.5%) developed culture-proven atypical mycobacterial infection of the resurfaced lower eyelid skin and were treated with combination antibiotic therapy for several months until resolution. A small scar was noted in 4 patients (0.9%), which resolved after local corticosteroid injections. No patient developed persistent scarring or ectropion. Patient satisfaction was overall high, with 363 (85.6%) very satisfied and 48 (11.3%) satisfied with the aesthetic outcome of lower eyelid laser resurfacing. CONCLUSIONS: Ablative carbon dioxide laser resurfacing of the lower eyelids can be a useful tool in the armamentarium of the experienced oculoplastic surgeon, with excellent aesthetic results, high patient satisfaction, and low complication rates as adjunctive or monotherapy. Proper and timely management of postoperative complications is essential to maximizing successful cosmetic outcomes.

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Published In

Ophthalmic Plast Reconstr Surg

DOI

EISSN

1537-2677

Publication Date

September 2021

Volume

37

Issue

5

Start / End Page

450 / 456

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Postoperative Complications
  • Patient Satisfaction
  • Ophthalmology & Optometry
  • Middle Aged
  • Lasers, Gas
  • Laser Therapy
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kim, J. S., Ginter, A., Ranjit-Reeves, R., & Woodward, J. A. (2021). Patient Satisfaction and Management of Postoperative Complications Following Ablative Carbon Dioxide Laser Resurfacing of the Lower Eyelids. Ophthalmic Plast Reconstr Surg, 37(5), 450–456. https://doi.org/10.1097/IOP.0000000000001902
Kim, Jane S., Anna Ginter, Roshni Ranjit-Reeves, and Julie A. Woodward. “Patient Satisfaction and Management of Postoperative Complications Following Ablative Carbon Dioxide Laser Resurfacing of the Lower Eyelids.Ophthalmic Plast Reconstr Surg 37, no. 5 (September 2021): 450–56. https://doi.org/10.1097/IOP.0000000000001902.
Kim JS, Ginter A, Ranjit-Reeves R, Woodward JA. Patient Satisfaction and Management of Postoperative Complications Following Ablative Carbon Dioxide Laser Resurfacing of the Lower Eyelids. Ophthalmic Plast Reconstr Surg. 2021 Sep;37(5):450–6.
Kim, Jane S., et al. “Patient Satisfaction and Management of Postoperative Complications Following Ablative Carbon Dioxide Laser Resurfacing of the Lower Eyelids.Ophthalmic Plast Reconstr Surg, vol. 37, no. 5, Sept. 2021, pp. 450–56. Pubmed, doi:10.1097/IOP.0000000000001902.
Kim JS, Ginter A, Ranjit-Reeves R, Woodward JA. Patient Satisfaction and Management of Postoperative Complications Following Ablative Carbon Dioxide Laser Resurfacing of the Lower Eyelids. Ophthalmic Plast Reconstr Surg. 2021 Sep;37(5):450–456.

Published In

Ophthalmic Plast Reconstr Surg

DOI

EISSN

1537-2677

Publication Date

September 2021

Volume

37

Issue

5

Start / End Page

450 / 456

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Postoperative Complications
  • Patient Satisfaction
  • Ophthalmology & Optometry
  • Middle Aged
  • Lasers, Gas
  • Laser Therapy
  • Humans
  • Female