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Background Studies of the laser treatment of nondermatophyte mold (NDM) onychomycosis are limited. Long-pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG) 1064-nm laser has been introduced as an adjuvant dermatophyte onychomycosis treatment. Aims To investigate the efficacy and safety of long-pulsed Nd:YAG 1064-nm laser for NDM onychomycosis treatment, compared with topical amorolfine nail lacquer alone and a combination treatment. Patients/methods This randomized controlled trial was conducted at the Nail Clinic, Siriraj Hospital. Patients diagnosed with NDM were included and randomly assigned to three treatment groups: laser at 1 month interval (1064-nm Nd:YAG at a fluence of 35 J/cm2 , pulse width 30 ms, and pulse rate 1.0 Hz); topical amorolfine nail lacquer alone; and a combination treatment. Results Sixty patients completed the study. The patients treated with the laser, amorolfine, and the combination achieved mycological cure rates of 35%, 60%, and 65%, respectively (P = .05), while 10%, 30%, and 30% of the patients in the respective groups were clinically cured. The mean durations to the mycological cures in the patients treated with laser, amorolfine, and the combination were 5.9, 4.8, and 5.2 months, respectively. By comparison, the corresponding mean durations to the clinical cures were 6.9, 6.5, and 5.9 months. Both the times to the mycological cures and the clinical cures did not differ significantly between the groups (P = .290 and P = .309, respectively). There were no serious complications with the laser treatment. Conclusions Laser alone achieved only a 30% mycological cure rate for NDM onychomycosis. The combination treatment yielded similar outcomes to the topical treatment alone.

Cryotherapy (or cryosurgery) has been performed to treat various skin lesions in the field of dermatology; however, to the best of our knowledge, no study has investigated its efficacy and safety for benign pigmented lesions. Therefore, we conducted a split-face study to evaluate the efficacy and safety of cryotherapy in the treatment of benign pigmented lesions. A total of five subjects were included. Picosecond laser therapy was performed to treat the whole face and cryotherapy for half the face. Four weeks after completing the treatment sessions, patients showed more clinical improvement on the laser and cryotherapy combination treatment side than on the laser-only side, with no adverse events. Our study demonstrated that cryotherapy is a potential adjuvant therapeutic modality for benign pigmented lesions. This article is protected by copyright. All rights reserved.

Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser treatment is performed on vitreous floaters, but studies of structural and functional effects with objective outcome measures are lacking. This study evaluated Nd:YAG laser effects by comparing participants with vitreous floaters who previously underwent laser treatment with untreated control participants and healthy persons without vitreous floaters using quantitative ultrasonography to evaluate vitreous structure and by measuring visual acuity and contrast sensitivity function to assess vision.Retrospective, comparative study.One eye was enrolled for each of 132 participants: 35 control participants without vitreous floaters, 59 participants with untreated vitreous floaters, and 38 participants with vitreous floaters previously Nd:YAG-treated. Of these, 25 were dissatisfied and sought vitrectomy; 13 were satisfied with observation.The 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-39) to assess participant visual well-being, quantitative ultrasonography (QUS) to measure vitreous echodensity, and best-corrected visual acuity (BCVA) and contrast sensitivity function (CSF) to evaluate vision.Results of NEI-VFQ-39, QUS, BCVA, and CSF.Compared with control participants without vitreous floaters, participants with untreated vitreous floaters showed worse NEI-VFQ-39 results, 57% greater vitreous echodensity, and significant (130%) CSF degradation (P0.001 for each). Compared with untreated eyes with vitreous floaters, Nd:YAG-treated eyes had 23% less vitreous echodensity (P0.001), but no differences in NEI-VFQ-39 (P = 0.51), BCVA (P = 0.42), and CSF (P = 0.17) results. Of 38 participants with vitreous floaters who previously were treated with Nd:YAG, 25 were dissatisfied and seeking vitrectomy, whereas 13 were satisfied with observation. Participants seeking vitrectomy showed 24% greater vitreous echodensity (P = 0.018) and 52% worse CSF (P = 0.006). Multivariate linear regression models confirmed these findings.As a group, participants previously treated with Nd:YAG laser for bothersome vitreous floaters showed less dense vitreous, but similar visual function as untreated control participants with vitreous floaters. Because some treated eyes showed less dense vitreous and better visual function than those of untreated control participants, a prospective randomized study of Nd:YAG laser treatment of vitreous is warranted, using uniform laser treatment parameters and objective quantitative outcome measures.

BACKGROUND Long-pulsed (LP) lasers at pulse durations of 1-300 ms have been used to destroy nests of nevi cells by selectively targeting pigment chromophores. OBJECTIVE To evaluate dual-wavelength LP laser-induced tissue reactions. METHODS The patterns of LP 755-nm alexandrite (Alex) and/or 1064-nm neodymium (Nd):yttrium-aluminum-garnet (YAG) laser-induced tissue reactions were macroscopically evaluated using a tattoo-embedded phantom. Additionally, a pilot in vivo human study was performed for common acquired melanocytic nevus, of which dermoscopic images and high-speed cinematographs were obtained. RESULTS Combinations of Nd:YAG and Alex laser treatments at interpulse intervals of 10 or 20 ms generated round to oval zones of photothermal and photoacoustic injury in two distinctive areas containing disintegrated tattoo particles. Treatment at interpulse intervals of 10 or 20 ms between Alex and Nd:YAG pulses elicited lesser degrees of thermal damage to surrounding tissues, compared to treatment at 100 or 200 ms. Immediately after combined LP laser treatment of human nevus lesions in vivo, Nd:YAG-Alex treatment at a 20-ms interpulse interval exhibited more remarkable crusting and erosive appearances than Alex-Nd:YAG treatment. CONCLUSION For treating pigmented disorders, sequential delivery of LP Nd:YAG and Alex pulses at short interpulse intervals of 10-20 ms can effectively destroy nests of pigment chromophores.

Introduction: A contemporary protocol for managing horizontal alveolar defects adjacent to immediate implants includes placement of a well-designed provisional restoration to contain graft material and seal the socket. However, immediate provisionalization is not always possible or practical.Case Presentation: A 39-year-old male presented with a non-restorable tooth #29, which was extracted. An immediate implant was placed in the tooth #29 position, and a freeze-dried bone allograft was placed in the horizontal defect between the implant platform and osseous walls. A neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used to create a stable fibrin clot over the graft material. After 31 months, favorable radiographic bone levels and complete papilla fill were noted.Conclusion: The present case illustrates use of an Nd:YAG laser in the management of an immediate implant horizontal defect in lieu of an immediate provisional restoration.

Keloids are benign tumors that originate from scar tissues, but they usually overgrow beyond the original wounds. In a three-month single-center clinical trial, 69 patients were randomly divided into three groups. Patients in group 1 were treated with intralesional injection of diprospan (2 mg betamethasone disodium phosphate and 5 mg betamethasone dipropionate in 1 ml) with one-month intervals for three months. Patients in groups 2 and 3 were injected with a combination of 0.5 ml 5-fluorouracil (5-FU; 25 mg/ml) and diprospan as above for three months also. Prior to each injection, the keloids of patients in group 3 were additionally irradiated by a 1,064-nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser with a single pulse at an energy density of 90–100 J/cm2 and a pulse width of 12 msec. Clinical responses were evaluated by patient self-assessment and overall assessment by an observer according to the clinical signs of erythema, pruritus and pliability. A total of sixty-two patients completed the tests of the present study. At 2 and 3 months, the patients in all treatment groups showed an acceptable improvement in nearly all measurements. At the end of the study, the erythema and toughness score was significantly reduced and itch reduction was significantly greater in the diprospan + 5-FU + Nd:YAG group when compared to those in the other groups (P

SummaryBackground Photothermal destruction of hair shaft melanin with intense pulsed light (IPL) and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser has become an effective treatment of hair removal. Aims Our aim was to compare efficacy, satisfactory levels, safety, and side effects of Nd:YAG and IPL in hair reduction. Methods This was a prospective randomized intrapatient, right-left, assessor-blinded comparison of Nd:YAG vs IPL. There were 38 volunteers recruited. Seven sessions were performed. Hair count, efficacy, and side effects were compared before and after each treatment and 6 months after the last treatment. In respect of 12 volunteers, we have examined the reduction in hair after 18 months. Results Initially, there was no significant difference between the numbers of hair follicles. There was significant hair reduction after each treatment on the Nd:YAG-treated side. The hair reduction became significant after the third treatment with IPL. Comparison of the efficacy of the two devices on each visits showed no significant difference. There was statistically lower pain score on the IPL-treated side and statistically higher erythema, burning sensation, and edema on the Nd:YAG-treated side. Statistically lower side effect score was observed on the IPL-treated side. Eight months after the last treatment, there was significant hair reduction both on the Nd:YAG and on the IPL-treated side, and there was no difference between the efficacy. The patient satisfaction scores were higher with the IPL. Conclusion Unwanted hair can be reduced by both systems safely and effectively; however, IPL has less side effects and higher satisfaction scores.

WOS: 000396876400006 PubMed ID: 27849400 Background: Several lasers have been used for the treatment of xanthelasma palpebrarum (XP), such as Q-switched neodymium: yttrium aluminum garnet (QSNd: YAG) and erbium: yttrium aluminum garnet (Er: YAG) laser. Up to now, a comparative study among these laser options in the treatment of XP has not been reported. Objective: The aim of this study was to compare the clinical efficacy and response rates of QSNd: YAG and Er: YAG in the treatment of XP. Methods: Sixty patients with a total of 102 XP lesions were randomly and equally divided into two groups. The first group was treated with QSNd: YAG at a fluence of 10 joule/cm(2), 10 Hz and 2 mm spot size, and the second group was treated with Er: YAG at 200-300 millijoule, 4 Hz and 2 mm spot size. Results: In the Er: YAG group, the percentage of patients who required 3 or 4 sessions and wound healing time were higher compared to those of the QSNd: YAG group. Furthermore, the percentage of patients who had an improvement score of 4 was higher in the Er: YAG than that in the QSNd: YAG group. Conclusion: Er: YAG is an efficient, successful and minimally invasive method without long-lasting adverse effects.

Introduction: Oral soft tissue lesions cause discomfort and potentially serious clinical problems.Case Series: These case reports present different gingival and/or mucosal lesions (pyogenic granuloma, verruca vulgaris, giant cell granuloma, fibroma, etc.) and the surgical treatment of these lesions with a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser (320-μm optic fiber; 4 W; 100 mJ, 40 Hz; emission mode, pulsed, and contact mode). Patients were evaluated after laser surgery on degree of postoperative pain; discomfort; functional complications (eating and speech); and recurrence. Results indicated that patients had minimal postoperative pain, few functional complications, and low rates of pain. Laser surgery produced minimal bleeding, damage to the surrounding tissue, and post-surgical edema.Conclusion: In these cases, the Nd:YAG laser provided a non-bleeding environment at the surgical area with an acceptable operating time, quick postoperative hemostasis, good patient acceptance, low rates of pain, a...

Laser treatment has emerged as a common treatment modality for acquired bilateral nevus of Ota-like macules (ABNOM). To identify the ratio of melasma induction and exacerbation before and after laser therapy for ABNOM and to observe the risk factors related to the induction and exacerbation of melasma by laser therapy, we analyzed related factors of 1268 adult Chinese patients who underwent 1064-nm Q-switched neodymium:yttrium-aluminum-garnet (Nd:YAG) laser (QNYL) treatment using case series and case-control studies. Overall, 24.0% of the ABNOM patients had mixed melasma. Among the ABNOM patients without melasma, after laser therapy the development of melasma was more frequently noted in patients older than 35 years (P < 0.0001), as well in patients whose ABNOM was less than 10 cm(2) (P = 0.027), ABNOM were light (similar to yellow-brown) in color (P = 0.021) and skin types were closer to type IV (P < 0.0001). New melasma lesions also appeared most frequently in the zygomatic region (P < 0.0001). Among the ABNOM patients with melasma, 89.5% experienced worsening of their melasma, irrespective of their related factors above. We concluded that the risk of inducing melasma is great after 1064-nm QNYL treatment in ABNOM patients, and particularly in the patients with both ABNOM and melasma. ABNOM patients should be treated as early as possible and before the age of 35 years.

Objective: To find out whether there exists a correlation between the quantum of energy used and the amount of rise of intraocular pressure (IOP) following neodymium: yttrium aluminum garnet (Nd: YAG) laser capsulotomy. Materials and Methods: A total of 110 patients who had undergone Nd: YAG laser posterior capsulotomy for the management of posterior capsule opacification with a minimum of 3 months following cataract surgery were enrolled after taking written informed consent. After detailed history and ocular examination, Nd: YAG laser capsulotomy was performed. Prelaser IOP was noted. Nd: YAG laser posterior capsulotomy was performed. Laser energy used was noted following which postlaser IOP was also recorded after 1, 2, and 4 h postprocedure. Paired t-test was used for the comparison of means of IOP and energy levels. Receiver operating characteristic analysis was used to predict the cut-off value of energy on the basis of change of IOP from baseline. Results: The mean energy used in the Nd: YAG laser posterior capsulotomy procedure for all patients was 58.57 ± 34.63 mJ. The mean IOP at 1st h follow-up was 15.32 ± 2.91 mmHg, at 2nd h follow-up was 16.24 ± 3.23 mmHg, and at 4th h follow-up was 16.18 ± 3.35 mmHg. At all three follow-ups, the mean change in IOP was found to be statistically significant (P < 0.001). Conclusion: Postlaser IOP rise is minimal and transient; it varies with the amount of energy used.

Common warts (verruca vulgaris) are the most commonly seen benign cutaneous tumors. However, warts in the hands and feet regions often respond poorly to treatment, some are resistant to more than 6 months of treatment with currently available modalities, including cryotherapy, being defined as refractory warts. We investigated the usefulness of long-pulsed neodymium:yttrium-aluminum-garnet (LP-Nd:YAG) treatment for refractory warts. The clinical trial was conducted on 20 subjects (11 male, nine female) with a total of 34 lesions (periungual/subungual areas, plantar areas, fingers and/or toes). All the subjects suffered from refractory warts despite conventional treatments for more than 6 months. The patients were administrated up to six sessions of treatment, at intervals of 4 weeks between sessions, with an LP-Nd:YAG at a spot size of 5 mm, pulse duration of 15 msec and fluence of 150-185 J/cm(2) . Evaluation of the treatment results at 24 weeks after the initial treatment showed complete clearance of the refractory warts in 56% of the patients. Histological evaluation showed separation of the dermis and epidermis at the basement membrane with coagulated necrosis of the wart tissue in the lower epidermis, as well as coagulation and destruction of the blood vessels in the papillary dermis following the laser irradiation. No scarring, post-hyperpigmentary changes or serious adverse events were documented. Our preliminary results show that LP-Nd:YAG treatments are safe and effective for refractory warts of hands and feet, causing minimal discomfort, and is a viable treatment alternative.

Background Facial erythema is a common symptom that responds to vascular laser treatment, but there are few comparative studies. Objective We sought to compare the effectiveness of microsecond 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser with nonpurpuragenic 595-nm pulsed dye laser (PDL) for diffuse facial erythema. Methods This was a split-face, double-blind randomized controlled trial. Bilateral cheeks received 4 treatments each at one month intervals with PDL or Nd:YAG. Spectrophotometer measurements, digital photographs, pain scores, and patient preferences were recorded. Results Sixteen patients enrolled and 2 dropped out. Fourteen patients, all skin types I to III, 57% women, mean age 42 years, completed the study and were analyzed. Spectrophotometer readings changed after both PDL (8.9%) and Nd:YAG (2.5%), but varied by treatment type, with PDL reducing facial redness 6.4% more from baseline than Nd:YAG ( P = .0199; 95% confidence interval −11.6 to −1.2). Pain varied ( P = .0028), with Nd:YAG associated with less pain, at 3.07, than PDL at 3.87. Subjects rated redness as improved by 52% as a result of PDL, and 34% as a result of Nd:YAG ( P = .031; 95% confidence interval −34.6 to −1.94). No serious adverse events were observed. Limitations Lasers settings are not standardized across devices. Conclusion Facial erythema is safely and effectively treated with PDL and Nd:YAG. Nonpupuragenic PDL may be more effective for lighter-skinned patients, but microsecond Nd:YAG may be less painful.

Introduction: Laser and light-based procedures provide a good and safe modality for treatment of active acne lesions when used properly. Aim: To compare the clinical efficacy of intense pulsed light (IPL) versus 1,064 long-pulsed Neodymium:Yttrium–Aluminum– Garnet (Nd: YAG) in treatment of facial acne vulgaris. Materials and Methods: Seventy four patients recruited between June 2013 and August 2014 was enrolled in this controlled, single-blind, split-face clinical trial. All participants received 3 sessions of IPL on the right side of the face and 1,064- nm Nd:YAG on the left side of the face at 4-weeks intervals. Final assessment was made by comparison of the changes in the count of inflammatory acne lesions (inflammatory papules, pustules, nodules and cyst) and non-inflammatory acne lesions (Comedones) and the acne severity score between both therapies, based on standardized photography. Results: At the final visit, the inflammatory acne lesions were reduced on the IPL and 1,064-nm Nd:YAG treated sides by 67.1% and 70.2% respectively (p0.05 for each). For both therapies, there was significant difference in the improvement on inflammatory acne lesions in comparison to non-inflammatory lesions (p0.05 for each). Conclusion: Both IPL and 1,064-nm Nd:YAG laser are effective in treatment of inflammatory facial acne vulgaris. There is no significant difference between the effects of both therapies on facial acne lesions.

Despite a quarter of a century of laser research, there is a persistent debate regarding the efficacy of dental lasers in the treatment of periodontitis or periodontal maintenance therapy. There are many claims and much hyperbole surrounding the use of lasers, either as a monotherapy or adjunctive to scaling and root planing, to treat periodontitis. There is little evidence that using a diode or neodymium:yttrium-aluminum-garnet laser adds clinical value over and above conventional non-surgical or surgical periodontal treatment. There is a significant need for better designed human clinical trials. Data from such trials should be analyzed according to initial probing depth and characteristics of the treated sites, such as non-molar, molar flat surfaces, and molar furcations, and evaluated for long-term post-treatment results.

Background and objectives: Treatment of mucosal vascular lesions is a challenge for dermatologists, although various approaches have proven efficacy, including surgery, sclerotherapy, intralesional injection of corticosteroids, transfixion, and laser therapy. The aim of this study was to describe the results of treatment with neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in 11 patients with venous malformations and varicosities. Patients and methods: We describe the use of variable-pulse Nd:YAG to treat venous malformations or varicosities in the oral or genital mucosa of 8 women and 3 men seen in our hospital over a 1-year period.

Purpose To evaluate the clinical outcomes in patients with recurrent corneal erosions who received anterior stromal puncture by use of neodymium:yttrium–aluminum–garnet (Nd:YAG) laser. Design Retrospective, nonrandomized, consecutive case series. Participants From 2000 to 2005, 33 eyes of 33 patients with unilaterally recurrent macroform corneal erosions showing poor response to conservative management who were treated with Nd:YAG laser were studied. Intervention Anterior corneal stromal puncture with Nd:YAG laser was performed in the loosened epithelium or epithelial defect area. The causes and frequency of corneal erosions and the spot numbers and total energy of the Nd:YAG laser were recorded. Slit-lamp biomicroscopic examination, refraction, corneal topography, and times of laser were reviewed. A questionnaire regarding the preoperative and postoperative difference in the intensity of pain and frequency of corneal erosion was provided. Main Outcome Measures Rate of recurrence and pain assessment by numerical rating scale. Results Sixteen eyes were completely symptom free and 12 eyes had mild pain but no evidence of recurrent corneal erosion after operation. Five eyes had repeated episodes of recurrent corneal erosion. Eyes with a traumatic cause responded better to Nd:YAG laser therapy than those without. The frequency of corneal erosions and the severity of pain significantly improved in eyes with macroform and symptom-only recurrence. There was no significant change in refraction, but corneal surface regularity slightly improved after surgery. No adverse reaction was observed during follow-up. Conclusions Anterior stromal puncture by Nd:YAG laser is an effective and simple procedure to treat recurrent corneal erosion. It can ameliorate the frequency of attacks and the intensity of pain. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Summary Background Laser hair removal has become an accepted form of long-term hair reduction and is now one of the most common dermatologic procedures. Trichoscan is a validated method of assessing hair length, thickness, and density and growth rate using dermoscopy. Objective The study aimed to evaluate the trichoscopic changes during treatment of hirsutism with 1064-nm neodymium:yttrium–aluminum–garnet laser. Methods Seventy patients with idiopathic facial hirsutism referring to the laser centers of Al-Azhar University hospital (Asyut and Cairo) between December 2012 and October 2014 were enrolled in this open-label, multicentric study. All participants received six sessions of 1064-nm Nd:YAG laser at 4-week intervals. Mean hair density/cm2, percentage of terminal/vellus hair ratio, and hair thickness (mm) were assessed at baseline and 1 month after each session for six sessions using trichoscan. Results Seventy female patients completed the study protocol. At the final visit, mean hair density, terminal/vellus hair ratio, and hair thickness were significantly decreased from baseline (73.7 + 20.6, 72.5 + 14.7, 0.095 + 0.02, respectively) to (19.4 + 5.6, 21.3 + 5.2, 0.02 ± 0.007, respectively) (P

Objective: Laser treatment of port-wine stain (PWS) might be improved using a deeply penetrating wavelength. Methods: PWSs in 17 patients were treated 3 times with a 595-nm pulsed dye laser (PDL) and a 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Fluences of 1.0, 0.8, and 0.6 times the minimum purpura dose (MPD) were used for Nd:YAG laser. Posttreatment biopsy specimens were taken. Blind assessment and quantitative analysis of PWS clearing were performed from digital photographs. Results: MPD for Nd:YAG laser varied widely, from 40 to 250 J/cm 2 . Purpura lasted longer after PDL. Treatment achieved similar 50% to 75% clearing with both PDL and Nd:YAG laser at 1 MPD. Nd:YAG caused greater perivascular and epidermal injury. Scarring occurred in the only patient treated with a Nd:YAG fluence greater than 1 MPD. Patients preferred Nd:YAG laser because of their faster recovery. Conclusion: Nd:YAG laser used at MPD is as effective as PDL for treating PWS. Nd:YAG laser fluences higher than MPD may cause scarring. ( J Am Acad Dermatol 2005;52:480-90.)

Summary Glomovenous malformations are disseminated variants of cutaneous glomus tumors. These malformations are subdivided into regional or localized, disseminated, and congenital plaque-like forms. The congenital plaque-like form is the rarest variant. Most treatment modalities have been disappointing in the treatment of large glomangiomas, leading to high recurrence rates. We report a case of a 34-year-old man with a congenital plaque-like glomangioma on his left arm and forearm treated successfully with sequential pulsed-dye neodymium yttrium aluminum garnet laser.

Laser cyclophotocoagulation is an accepted method of cyclodestruction, such as cyclocryothermy and the application of cyclodiathermy, microwaves and ultrasound. These procedures may be considered as ultima ratios or ‘last-resort interventions’. Also, in cases where surgery is not possible, cyclodestruction may be the initial intervention. Among other lasers, the Nd:YAG and diode lasers are the energy sources of choice. Contact and noncontact methods have about the same clinical efficiency and risk. While immediate complications are transitory, other, late complications, mentioned in the world literature, such as sympathetic ophthalmia, malignant glaucoma and retinal detachment, are more serious but are rare, and their causal relationship with the cyclodestructive procedure is doubtful. However, they still merit our attention. The ultrastructural mechanisms related to cyclocoagulation have been studied. The study of aqueous flow may improve our understanding of cyclophotocoagulation techniques. Cyclophotocoagulation is considered an important cornerstone in glaucoma therapy. The uncertainty of its effect is no greater than that of any other therapeutic measure in the treatment of glaucoma.

Background: Pseudofolliculitis barbae affects a large number of individuals with coarse curly hair, and present treatment options are suboptimal. Objective: We evaluated the safety and efficacy of a long-pulsed neodymium:yttrium aluminum garnet (Nd:YAG) laser in the treatment of pseudofolliculitis barbae. Methods: This was a two-phase observational study conducted at a military tertiary medical facility. The study group included 37 patients (skin types IV, V, and VI) referred from primary care physicians with a diagnosis of pseudofolliculitis barbae refractory to conservative therapy. In phase I, one treatment with a Nd:YAG laser was performed on a tattooed area of the thigh with 3 light doses. Epidermal tolerance was evaluated, and hair counts were performed 3 months after treatment for each light dose. In phase II, the highest dose tolerated by the epidermis from phase I was applied to a small submental region of skin with an adjacent site as a control. Subsequently, papule counts were performed 90 days after treatment in the laser-irradiated and control areas. Results: Phase I: When normalized for controls, there was 33%, 43%, and 40% hair reduction on the thigh for the 50, 80, and 100 J/cm 2 fluences, respectively, after 90 days. Overall, the highest doses tolerated by the epidermis were 50, 100, and 100 J/cm 2 for type VI, V, and IV skin, respectively. Phase II: Mean papule counts after 90 days were 6.95 and 1.0 for the control and treatment sites, respectively. Conclusion: Nd:YAG laser treatment may represent a safe and effective option for reducing hair and subsequent papule formation in patients with pseudofolliculitis barbae. (J Am Acad Dermatol 2002;47:263-70.)

Background Low fluence 1,064 nm Q-switched (QS) Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser treatment, also known as laser toning, is widely used for pigmentary disorders. There has been no reliable evaluation of the effect of low fluence 1,064 nm QS Nd:YAG laser for senile lentigo. Objective To investigate the beneficial effect of low fluence 1,064 nm QS Nd:YAG laser in the treatment of senile lentigo on the face. Methods A retrospective review was conducted on patients treated only with repetitive low fluence 1,064 nm QS Nd:YAG laser. Among them, 12 patients with multiple senile lentigines before treatment were included. All side effects were recorded to assess the safety of the modality. Results Mean age was 56.1±7.8 years old and male-to-female ratio was 1:11. Mean treatment fluence was 1.62±0.16 J/cm2 and mean total treatment session was 8.8±2.6. Mean interval period between each session was 28.0±11.4 days and mean treatment session to reach marked and near total improvement was 8.7±2.8. At the final visit, seven of 12 (58.3%) patients reached marked and near total improvement, and three of 12 (25.0%) reached moderate improvement. No side effects occurred. Conclusion Repetitive low fluence 1,064 nm QS Nd:YAG laser treatment may be an effective and safe optional modality for senile lentigo.

Purpose: To evaluate changes in anterior chamber depth (ACD) and angle width after neodymium- yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy.Design: Prospective interventional case series.Methods: In a single institution, 43 eyes of 43 consecutive pseudophakic patients with symptomatic posterior capsule opacification (PCO) underwent Nd:YAG laser capsulotomy. Anterior chamber depth and angle width in pseudophakic eyes with posterior capsule opacification were measured with anterior segment optical coherence tomography (AS-OCT) before and 3 days after Nd:YAG laser capsulotomy. Preoperative and postoperative measurements of anterior chamber depth and angle width included the angle opening distance, measured as the perpendicular distance from the trabecular meshwork at 500 mm and 750 mm anterior to the scleral spur to the anterior iris surface (AOD500 and AOD750, respectively), and anterior chamber angle (ACA) in the nasal and temporal quadrants. Main outcome measures were the changes in ACD and angle width parameters.Results: The mean patient age was 63.4 ± 3.6 years. Before Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurementswere 3.71 ± 0.11mm, 0.61 ± 0.054mm, 0.67 ± 0.063 mm, and 34.5 ± 1.67 degrees and 34.8 ± 1.55 degrees, respectively. Three days after Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.77 ± 0.1 mm, 0.69 ± 0.06 mm, 0.73 ± 0.06 mm, and 35.51 ± 1.64 degrees and 36.17 ± 1.51 degrees, respectively (P