Diode Green Laser in the Lid Trichiasis Treatment
Purpose: To validate the standard values and evaluate the success rate in the treatment of minor and major trichiasis using thermoablation with a diode green laser.
Methods: In this interventional prospective study, individuals with minor or major trichiasis who were treated with thermoablation using diode green laser were included. The patients’ mean age was 72.1 years; the majority were females (54.1%) and Caucasian (98%). The parameters of the diode laser were wavelength of 532 nm, application time of 200 ms, target size of 50 μm, interval between the shots 150 to 200 ms, and power of 600 to 750 mW. The number of shots was defined by the depth of ablation sufficient to reach the pilus hair bulb. The patients were evaluated by slit-lamp every 3 to 4 months, for up to 15 months. The treatment success rate and the association between variables were analyzed.
Results: The study sample was comprised of 98 patients with 135 affected lids and 337 lashes with trichiasis. Minor trichiasis (91.8%), unilateral trichiasis (67.3%), trichiasis affecting the lower eyelid (85.9%), and trichiasis resulting from blepharitis (64.3%) were the most common presentation profiles. The overall cure rate at the end of the study was 85%, with 69% being cured with a single session and 82.8% with two treatment sessions.
Conclusion: Thermoablation using a diode green laser applying the specified parameters to treat minor and major trichiasis is effective and results in high cure rate.
Ablation Techniques, Diode Lasers, Success Rate, Trichiasis
1. Hanumanthu S, Webb LA, Lee WR, Williamson J. Histological and morphometric analysis of the effects of argon laser epilation. Br J Ophthalmol 2003;87;984– 987.
2. Ferreira IS, Bernardes TF, Bonfioli AA . Trichiasis. Semin Ophthalmol 2010;25:66–71.
3. Rajak SN, Collin JRO, Burton MJ. Trachomatous trichiasis and its management in endemic countries. Surv Ophthalmol 2012;57:105–135.
4. Fonseca Jr NL, Lucci LMD, Paulino LV, Rehder JRCLi. Argon laser in the treatment of trichiasis. Arq Bras Oftalmol 2004;67;277–281.
5. Moore J, De Silva SR, O’Hare K, Humphry RC. Ruby laser for the treatment of trichiasis. Lasers Med Sci 2009;24;137–139.
6. Pham RTH, Biesman BS, Silkiss RZ. Treatment of trichiasis using an 810-nm diode laser: an efficacy study. Ophthal Plast Reconstr Surg 2006;22;445–447.
7. Sahni J, Clark D. Argon laser and trichiasis: a helpful tip. Br J Ophthalmol 2001;85:762.
8. Al-Bdour MD, Al-Till MI. Argon laser: a modality of treatment for trichiasis. Int J Biomed Sci 2007;3:56–59.
9. Campbell DC. Thermoablation treatment for trichiasis using the argon laser. Aust N Z J Ophthalmol 1990;8:427–430.
10. Sharif KW, Arafat AFA, Wykes WC. The treatment of recurrent trichiasis with argon laser photocoagulation. Eye 1991;5:591–595.
11. Huneke JW. Argon laser treatment for trichiasis. Ophthal Plast Reconstr Surg 1992;8:50–55.
12. Gossman MD, Yung R, Berlin AJ, Brightwell JR. Prospective evaluation of the argon laser in the treatment of trichiasis. Ophthalmic Surg 1992;23:183–187.
13. Bartley GB, Lowry JC. Argon laser treatment of trichiasis. Am J Ophthalmol 1992;113:71–74.
14. Yung CW, Massicotte SJ, Kuwabara T. Argon laser treatment of trichiasis: a clinical and histopathologic evaluation. Ophthal Plast Reconstr Surg 1994;10:130–136.
15. Yeung YM. Argon laser treatment of trichiasis in Hong Kong. Br J Ophthalmol 1995;79:506–507.
16. Hata MM, Schellini SA, Aragon FF, Monteiro ECL, Padovani CR. [Argon laser in trichiasis and distichiasis treatment]. Arq bras oftalmol 1999;62:285–295.
17. Oguz H, Aras C, Ozdamar A. Thermoablation treatment for trichiasis in trachoma using the semiconductor diode pumped laser. Eur J Ophthalmol 1999;9:85–88.
18. Strempel I, Strempel H, Lange P. Treatment of trichiasis with a diode laser. Ophthalmologe 2000;97:633–634.
19. Wanzeler ACV, do Nascimento MF, Sousa RLF, Padovani CR, Schellini SA, Wanzeler ACV, et al Eyelid disorders: frequency of occurrence and profile of carriers in a Brazilian population sample. Rev Bras Oftalmol 2015;74:231–234.
20. Başar E, Ozdemir H, Ozkan S, Cicik E, Mirzataş C. Treatment of trichiasis with argon laser. Eur J Ophthalmol 2000;10:273–275.
21. Rodrigues ER, Zotter R. Manual do Usuário - VISULAS 532s instructions to use [Internet]. [cited 2018 Jun 2]. Available from: http://www.eyesolution.com.br/pdf/Visulas532.pdf
22. Drummond AM de C, Monteiro EC, Gouvea PMP de (2007). Confiabilidade metrológica de equipamentos eletromédicos a laser e a luz intensa pulsada. Pontifical Catholic University of Rio de Janeiro; 2007. Available from: https://www.maxwell.vrac.puc-rio.br/Busca_etds. php?strSecao=resultado&nrSeq=10706@1