Treatment of lower eyelid rhytids and laxity with ablative fractionated carbon-dioxide laser resurfacing: Case series and review of the literature

BackgroundAn increasing array of minimally invasive treatment modalities have evolved for periorbital rhytids. Nonablative fractional photothermolysis has been demonstrated to be effective for periorbital rhytids.ObjectiveWe sought to prospectively evaluate eyelid tightening with an ablative fractional photothermolysis laser.MethodsWe conducted a prospective, single blinded study for lower eyelid laxity in 25 subjects with a series of 2 to 3 treatment sessions.ResultsThe number of treatment sessions required for significant improvement of eyelid laxity ranged from 2 to 3, with an average of 2.44 sessions. For skin texture, the mean score decreased from 3.6 to a mean of 1.2 at 6 months posttreatment (P < .05) for a 62.6% mean improvement. For skin laxity, the mean score decreased from 3.3 to 1.3 at 6 months posttreatment (P < .05) for a 65.3% mean improvement. For rhytids, the mean score decreased from 3.5 to 1.3 at 6 months posttreatment (P < .05) for a 62.1% mean improvement. For overall cosmetic outcome, mean score decreased from 3.6 to 1.2 at 6 months posttreatment (P < .05) for a 65.7% mean improvement. Patients noted moderate postoperative erythema and edema that resolved by the 1-week posttreatment visit. Patients reported minor crusting and oozing that resolved within 48 to 72 hours.LimitationsThis is a prospective, single blinded study in 25 patients with varying degrees of laxity and photoaging affecting eyelid skin. Additional studies assessing degree of improvement for patients with varying degrees of laxity and photoaging at variable parameters are needed.ConclusionEyelids can achieve significant improvement in skin texture and laxity with ablative fractional photothermolysis.