Comparison of the 595 nm long-pulse (1.5 msec) and ultralong-pulse (4 msec) lasers in the treatment of leg veins

BACKGROUND. Although several lasers and light sources are now available for vascular lesions, treatment of leg veins has not been very satisfactory. L engthening the pulse width should theoretically result in improved response rates. OBJECTIVE. This study compared the efficacy and safety of 595 nm pulsed las ers at 1.5 msec and 4 msec in treating leg veins. METHODS. For group A, 27 healthy adult volunteers with leg veins measuring less than 1 mm in diameter were treated with a 2 mm x 7 mm elliptical handp iece. Each patient had three areas treated. The first two areas were treate d with the 4 msec pulsed dye laser with fluences of 16 and 20 J/cm(2), whil e the last area was treated with a 1.5 msec pulsed dye laser at fluences ra nging from 14 to 16 J/cm(2). For group B, 13 subjects were treated. Areas 1 and 2 were treated with the 4 msec pulsed dye laser using a 3 mm x 5 mm an d 5 mm handpiece, respectively, while the third site was treated with a 1.5 msec laser using a 3 mm x 5 mm handpiece. Fluences ranging from 14 to 16 J /cm(2) were used. Clinical evaluations were performed and photographs taken at 4-8 week intervals. RESULTS. Neither laser regularly induced satisfactory diminution or disappe arance of these vessels after one treatment. In group A, more than 50% of p atients had little to no improvement, while in group B little to no improve ment was observed in 33% of patients following a single treatment. Although there was no significant difference in outcomes between the test sites, th e 4 msec PDL with a 3 mm x 5 mm spot size appeared to be most effective. Tr ansient hyperpigmentation was common following either treatment, while hypo pigmentation was seen in group B subjects. No scarring was noted. CONCLUSION. Both the 4 and 1.5 msec flashlamp-pumped pulsed dye lasers were ineffective in treating leg telangiectasia following a single treatment.