A pilot study on the efficacy of 10600 nm carbon dioxide laser ablation in treatment of eyelid margin lesions.

Abstract

Objectives: Eyelid margin lesions cause discomfort by impeding both central and peripheral vision, depending on their position on the eyelids, thus hindering everyday routines. However, surgical excision, radiofrequency, electrocautery, and cryosurgery are employed for treatment, although they are complicated and have functional limitations. Carbon dioxide (CO₂) lasers were used to assess the efficacy, safety, and patient satisfaction with CO₂ laser ablation in managing eyelid margin lesions.

Material and methods: This is a pilot study of patients with eyelid margin lesions presented to a private clinic in urban Gujarat between June 2020 and June 2023. All patients were treated with a 10600 nm CO₂ laser with a power of 1-2 W in continuous mode. The eyelid lesions were classified into three categories based on their size: Small (1-3 mm), medium (4-6 mm), and large (7-10 mm). The clinical response was assessed by the treating physician at week 1 and week 4, and categorized as excellent (complete clearance of lesion), moderate (>50%), or poor (<50%). Patients were asked to rate their level of satisfaction on a three-point scale at the end of the follow-up period: Dissatisfied, somewhat satisfied, or very satisfied.

Results: Ten patients of all females with six of them having compound melanocytic nevi, two of them each had cystic hidradenoma, and one each had cyst of zeis and verruca vulgaris. Six of them had small lesions, two had medium, and two had large lesions. The clinical response grading of physicians at both 1 week and 4 weeks was excellent, and the patient satisfaction questionnaire yielded excellent outcomes.

Conclusion: The ablative CO₂ laser is an excellent device used for the treatment of eyelid margin lesions, particularly when performed by an expert and skilled dermatologist. The application of this treatment approach has proven to be very beneficial and shows excellent results in terms of both the esthetic appearance and structural function of the eyelids.