Intraoperative suprachoroidal hemorrhage in congenital glaucoma associated with cutis marmorata telangiectatica congenita.
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Copper vapor lasers emit pulsed light at 511 and 578 nm. The 578-nm option corresponds with a peak in the absorption of oxyhemoglobin and a diminished absorption by melanin. The pulse width of this light (20 nanoseconds) is significantly shorter than the thermal relaxation time of typical facial telangiectatic vessels (20 to 100 milliseconds). This laser is therefore able to selectively destroy facial telangiectatic vessels with little damage to the overlying epidermis. Twenty patients with facial telangiectasia were treated with the 578-nm option of a copper vapor laser. Treatment was administered in an office-room setting, and no anesthesia was used. Eighteen of the 20 patients experienced satisfactory clearance of their telangiectasia. Three patients developed temporary postinflammatory hyperpigmentation, which cleared within 6 to 8 weeks, and one patient developed a small depressed scar, which was not noticeable at 3 months. Copper vapor lasers are thus safe and effective in treating facial telangiectasia.
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BACKGROUND AND OBJECTIVE: Pulsed dye lasers (PDL) operating at 585 nm wavelength and 0.45 msec pulsewidth offer effective treatment for port wine stains (PWS). Vessels in leg telangiectasias are larger than those in PWS. Longer pulsewidths and wavelengths may improve clearance of these larger vessels. STUDY DESIGN/MATERIALS AND METHODS: Twenty patients were treated using PDL at 595 nm and 1.5 msec. Vessel diameters ranging from 0.635 to 1.067 mm were treated using energy densities of 15 and 18 J/cm2, and a 2 x 7 mm elliptical spot. Telangiectasia clearance and complications were scored at 6-weeks and 5-months following the single treatment. RESULTS: Results demonstrated > 50% clearance by 6 weeks in 11/26 (42.3%) patients using 15 J/cm2, and 6/13 (45.2%) using 18 J/cm2. By 5 months > 50% clearance was noted in 18/34 (53.0%) using 15 J/cm2, and 11/17 (64.7%) using 18 J/cm2. Complications were minor and infrequent. CONCLUSION: The long-pulse PDL may have a role in treating leg telangiectasias.
BACKGROUND AND OBJECTIVE: The optimal parameters for treatment of leg telangiectasia with a pulsed laser are investigated. STUDY DESIGN/MATERIALS AND METHODS: The Monte Carlo method is used to calculate the light penetration and absorption in the epidermis, dermis, and the ectatic blood vessel. Calculations are made for different diameters and depths of the vessel in the dermis. In addition, the oxygen saturation of the blood vessel, the laser beam diameter, and the laser irradiation profile is varied. RESULTS: It is found that for vessels with diameters between 0.3 mm and 0.5 mm wavelengths about 600 nm are optimal to achieve selective photothermolysis for the considered damage model. It is also shown that an elliptical laser beam area has advantages compared to a circular beam area for treatment of leg telangiectasia. CONCLUSIONS: We recommend the treatment of leg telangiectasia with dye laser wavelengths longer than the normally used 577 nm and 585 nm.
BACKGROUND AND OBJECTIVE: Various yellow light lasers have been used over the past decade in an attempt to eradicate facial telangiectasia. Based on their power output, spot size, and pulsing characteristics, these lasers belong to one of two categories that exist at either end of a spectrum--high power, short pulse, and large spot size, or low power, long exposure, and small spot size. The copper bromide laser clearly belongs in the latter group, but with higher available power than most other lasers in this group, it exists further along the spectrum toward the region in which the laser parameters might be considered closer to theoretical ideals for treating certain cutaneous vascular pathologies. The objective of this study was to ascertain the role and efficacy of the copper bromide laser on treatment of a variety of facial telangiectasia. STUDY DESIGN/MATERIALS AND METHODS: A total of 570 patients with facial telangiectasia of different diameters and on different regions of the face were treated with the copper bromide laser one or more times and followed up over 5 years. RESULTS: More than 75% clearance was achieved in 70% patients, 50-75% clearance in 17.4% patients, and < 50% clearance in 12.6% patients. Poor results were correlated with anatomical location on the nasal alae and nasal tip and also with vessel size. Very small (< 100 microns) and very large (> 300 microns) vessels did not respond as well as vessels in the 100-300-micron diameter group. Very large vessels responded better to a combination of sclerotherapy and laser treatment. There were no reported long-term adverse effects. CONCLUSION: The copper bromide laser is a safe and effective modality for the treatment of the majority of facial telangiectasia. It is less suited to treating very small vessel lesions such as diffuse erythema, and conversely very large vessels as well as those of the nasal alae. These latter two groups respond better and more permanently to combined sclerotherapy and laser treatment.