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Published on: September 27, 2024
Lower eyelid CO(2) laser rejuvenation: a randomized, prospective clinical study
S R Carter1, S R Seiff, P H Choo
1Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.
Purpose:
The effect of transconjunctival blepharoplasty alone compared with transconjunctival blepharoplasty and CO(2) laser skin resurfacing on lower lid bulging and wrinkles was examined.
Design:
Randomized clinical trial.
Participants:
Forty-four subjects, including 13 men and 31 women.
Methods:
Subjects were prospectively randomly assigned into two groups: (1) transconjunctival blepharoplasty with immediate CO(2) laser resurfacing or (2) transconjunctival blepharoplasty with CO(2) laser resurfacing 2 months later. Standardized photographs were taken before and 2 months after each procedure. A trained, masked observer graded the photographs.
Main Outcome Measures:
Bulging and wrinkles of the medial, central, and lateral portions of the lower lid were scored and compared at specified end points.
Results:
Transconjunctival blepharoplasty alone resulted in an improvement in lower lid bulging in 92% of subjects, whereas lower lid wrinkling worsened in 46%. When transconjunctival blepharoplasty was performed with simultaneous CO(2) laser resurfacing, or with CO(2) laser resurfacing 2 months later, a statistically significant improvement in wrinkles occurred (chi square = 20.625; P < 0.0005). The timing of the procedures had no statistically significant effect on final outcome. No subject had lower lid retraction develop.
Conclusions:
Transconjunctival blepharoplasty and adjunctive CO(2) laser resurfacing represents an excellent alternative to transcutaneous lower blepharoplasty. The procedure addresses lower lid wrinkles, skin redundancy, and fat herniation without a scar and with little risk of lower lid retraction.
