Purpose: To report on impact of Nd:YAG laser goniopuncture (LGP) timing on hypotensive efficacy of deep sclerectomy (DS) for open-angle glaucoma (OAG) patients. Methods: 228 patients who underwent DS followed by Nd:YAG LGP between January 2010 and December 2013, (follow up – 5 years) were enrolled into a single-center, retrospective, non-randomized, consecutive study. Subjects were divided into two groups (1 – delayed LGP, n = 116; 2 – early LGP, n = 112). Demographic variables, preoperative glaucoma medications, preceding surgeries and glaucoma severity were analyzed. Intraoperative and postoperative complications, intraocular pressure (IOP), ultrasound biomicroscopy (UBM) values were recorded. Success rate was analyzed using Kaplan-Meier curve. UBM data were the criteria for early or delayed LGP. Results: LGP was performed 3.46 ± 1.9 (1.5–6.7) months after DS in group 1, 1.12 ± 0.08 (0.9–1.5) months in group 2 ( p = 0.0001). Mean IOP before LGP in group 1 was 18.5 ± 4.7 (11.2–22.9) mm Hg; 15.7 ± 4.1 (9.1–18.5) mm Hg in group 2 ( p = 0.001). Choroidal effusion occurred in 8.6% of group 1 and 3.5% of group 2 ( p = 0.0001). Postoperative IOP: 15.6 ± 4.6 (group 1) and 15.7 ± 4.3 mm Hg (group 2) at 12 months ( p = 0.98), 16.7 ± 4.3 and 14.9 ± 1.6 mm Hg at 24 months ( p = 0.004), 16.8 ± 3.9 and 14.5 ± 3.2 mm Hg at 60 months, respectively ( p = 0.0001). Complete success rates: 68.07% and 92.59% at 12 months, 40.7% and 75.8% at 24 months, 15.2% and 48.93% at 36, 48, 60 months in groups respectively ( p = 0.0001). Conclusion: Early LGP after DS excludes TDM influence on further formation of intrascleral canal cavity and outflow pathways demonstrating pronounced hypotensive success in a long-term follow-up.
Background: A plethora of noninvasive approaches has been developed in recent years for facial rejuvenation. Energy-based devices have been one of the most popular treatments for reversing and preventing signs of facial aging such as fine lines, wrinkles, ptosis, and photoaging.
Aims:A new technology (RecoSMA) for skin rejuvenation based on acoustic-interference method using Er:YAG laser (2936 nm) equipped with a special module that targets both the dermis and the superficial musculoaponeurotic system (SMAS) was recently demonstrated to be safe and effective in facial rejuvenation.
Patient/Methods: In this follow-up prospective study, the clinical effects of recoSMA treatment on skin structures and SMAS were evaluated with ultrasound and histological analysis, at 30 and 90 days posttreatment.Results: Treatment with recoSMA was shown to result in a significant increase in thickness of the epidermis, dermis, and SMAS layer, while levels of collagen I, III, and IV were shown to be elevated at 90 days posttreatment.
Conclusion:Collectively, data show that treatment with recoSMA laser has a profound biological effect in stimulating and reconstructing the elastin/collagen framework necessary for preventing facial aging.
K E Y W O R D SEr:YAG laser, facial rejuvenation, histology, superficial musculoaponeurotic system, ultrasound
Facial aging is a complex biological process that affects the skin and superficial musculoaponeurotic system (SMAS). A new technology (RecoSMA) for skin rejuvenation based on acoustic-interference method using Er:YAG laser (2936 nm) equipped with a special module SMA that targets both the dermis and SMAS was evaluated in an open-label prospective cohort study of 100 female patients treated for facial rejuvenation. Measure of clinical improvement included investigator-rated clinical photography using the Modified Fitzpatrick Wrinkle Scale, and ultrasound measurements in the dermis a week, 30 days and six months post treatment. All patients completed the study and no complications were noted. Improvements in skin tone and texture were noted in all participants and significant decrease in wrinkle depth was demonstrated at the six-month follow-up that was confirmed by ultrasound skin measurements. Data presented herein confirm the safety and efficacy of RecoSMA treatment for facial rejuvenation.
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