Erbium-YAG and CO2 lasers in eyelid surgery

Background. Lasers are finding increasing use in cosmetic and reconstructiv e plastic surgery. We compared the erbium-YAG laser and the CO2 laser to co nventional eyelid surgery with a scalpel. Material and methods. We operated on 58 patients using the erbium-YAG laser and on 32 using the CO2 laser. Surgeries were benign tumor excisions and r emoval, xanthelasma removal,lower and upper eyelid blepharoplasties,and ski n resurfacing in the area of the lower eyelid. Results. Wound healing with the CO2 laser was significantly slower because of its larger thermal necrosis zone, but the hemostasis with the CO2 laser makes removal of deeper lesions easier. Advantages are the wide application spectrum for incisional and ablative surgery. The erbium-YAG laser is an e xcellent for ablating superficial benign lesions, including that in the are a of the lid margin and close to the lacrimal puncta without scars. Summary. The application spectrums of the erbium-YAG and CO2 lasers complem ent one another. The erbium-YAG laser is superior for esthetic skin resurfa cing and ablation of superficial lesions, and the CO2 laser allows hemorrha ge-free noncontact incisional surgery.