Treatment of trichiasis with argon laser

PURPOSE. In this prospective study, argon laser photocoagulation was used t o eliminate misdirected cilia. The cases were followed up to see the result s and recurrences with this treatment. METHODS. 60 eyelids of 45 patients with trichiasis were treated with the ar gon laser. After topical anesthesia a blue-green argon laser was used with 1 waft power, for 0.20 seconds, with 100 micrometer beam diameter. The beam was directed coaxially to the lash follicle to create a 2-3 mm crater and vaporization was observed. After crater formation, the laser parameters wer e changed to 1.2 watt power, for 0.20 seconds, with 200 micrometer beam dia meter, to destroy residual follicular tissue. Up to five lashes were treate d in one session. At the end of each session an antibiotic ointment was use d t.i.d. for a week. RESULTS. Patients have been followed for 4-12 months (mean 6 months). Recur rences have been seen in 15 of 60 eyelids (25%). Laser treatment has been u sed with the same protocol for the cases with recurrence and results have b een successful in eight of them. Postoperatively severe pain, hemorrhage, s car formation, neovascularization of lid margin, or infection were not seen in any patient. In three cases mild hypopigmentation and in three other ca ses mild lid notching were observed. CONCLUSIONS. Argon laser lash ablation can be done as an effective office p rocedure with topical anesthesia. The advantages include low recurrence and complication rates in carefully selected patients and minimal postoperativ e discomfort.