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      Cirugía de blefaroplastia por técnica convencional versus láser de CO2 Translated title: Blepharoplasty with conventional technique versus CO2 laser

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          Abstract

          Objetivo: presentar los resultados de la cirugía de blefaroplastia, con la técnica convencional y con el uso del láser de CO2. Método: se realizó un estudio descriptivo longitudinal y prospectivo en 50 pacientes que fueron atendidos en el Servicio de Oculoplastia del Instituto Cubano de Oftalmología «Ramón Pando Ferrer», con el diagnóstico de Dermatochalasis y/o hernia del tejido adiposo orbitario, de enero a junio del 2006. Se conformaron dos grupos de 25 pacientes seleccionados de forma aleatoria, uno para ser intervenido con láser y otro por la técnica convencional. Resultados: el mayor número de pacientes tratados quirúrgicamente por Dermatochalasis correspondió al grupo de edades entre 50 a 60 años, predominó la cirugía convencional. El 64,0 % representaba al sexo femenino, se le aplicó dentro de este grupo la técnica convencional a un 68,0 %. El 68,0 % correspondió a pacientes de piel blanca, con un uso de 76 % de láser de CO2. El 58,0 % de estos pacientes se le realizó la técnica quirúrgica en un tiempo comprendido entre 30 y 45 minutos. Las complicaciones fueron hiperpigmentación al aplicar el láser de CO2 y la hipocorrección al utilizar la técnica convencional. Conclusiones: ambas técnicas quirúrgicas muestran resultados satisfactorios para el paciente, por lo que se convierten en una solución al problema estético y funcional del mismo, pero con el uso del láser de CO2 se redujo las complicaciones y el tiempo quirúrgico, siendo así la alternativa preferida por médicos y pacientes.

          Translated abstract

          Objective: To present the results of blepharoplasty with the conventional technique and with CO2 laser. Method: Prospective, longitudinal and descriptive study of 50 patients with diagnosis of dermatochalasis and/or orbital fatty tissue hernia, who were assisted at the Oculoplasty service of "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from January to June 2006. Two groups of 25 randomly selected patients were created; one to be operated on with laser and the other with the conventional procedure. Results: The highest number of patients surgically treated from dermatochalasis lied in 50-60 y age group and the conventional surgery was predominant. Females accounted for 64% and in this group, the conventional technique was performed in 68% of patients. Sixty eight percent of patients were Caucasians, with use of CO2 laser amounted to 76%. The surgical time for 58% of these patients who underwent the surgical technique ranged 30 to 45 minutes. The complications were hyperpigmentation when using laser and hypocorrection when using the conventional technique. Conclusions: Both surgical techniques show satisfactory results for the patients, so they become solutions to their esthetic and functional problems; however, CO2 laser reduced complications and the surgical times, so it is the alternative of choice for physicians and patients alike.

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          Most cited references18

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          Cutaneous resurfacing with CO2 and erbium: YAG lasers: preoperative, intraoperative, and postoperative considerations.

          T S Alster (1999)
          The development and integration of pulsed and scanned CO2 and erbium:YAG laser systems into mainstream surgical practice over the past years has revolutionized cutaneous resurfacing. These lasers are capable of delivering to skin high peak fluences to effect controlled tissue vaporization, while leaving an acceptably narrow zone of residual thermal damage. The inherent technological differences that exist between the two distant laser systems in terms of ablation depths, degree of thermal coagulation, and postoperative side-effects and complications guide patient selection and management. This article reviews the basic principles of CO2 and erbium:YAG laser resurfacing, including preoperative, intraoperative, and postoperative patient considerations. Side-effects and complications encountered after laser resurfacing are discussed with specific guidelines provided on their appropriate management. Anticipated future developments and cutting-edge research endeavors in cutaneous laser resurfacing are also briefly outlined.
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            Laser blepharoplasty with transconjunctival orbicularis muscle/septum tightening and periocular skin resurfacing: a safe and advantageous technique.

            Carbon dioxide (CO2) laser blepharoplasty with orbicularis oculi muscle tightening and periorbital skin resurfacing is a safe procedure that produces excellent aesthetic results and diminishes the occurrence of complications associated with skin and muscle resection in the lower lid, particularly permanent scleral show and ectropion. The authors present a review of 196 cases of carbon dioxide laser blepharoplasty and periocular laser skin resurfacing performed at their center from April of 1994 to September of 1998. Of these cases, 113 patients underwent four-lid blepharoplasty, 59 underwent upper lid blepharoplasty only, and 24 underwent lower lid blepharoplasty only. Prophylactic lateral canthopexy was performed in 24 patients. Concomitant procedures (brow lift/rhytidectomy/rhinoplasty) were performed in 92 patients. The carbon dioxide laser blepharoplasty procedure resulted in no injuries to the globe, cornea, or eyelashes. Combined with laser tightening of the orbicularis oculi muscle and septum and periocular skin resurfacing, the transconjunctival approach to lower blepharoplasty preserves lower lid skin and muscle. Elimination of the traditional scalpel skin/muscle flap procedure results in a dramatically lower complication rate, particularly with regard to permanent ectropion and scleral show. Laser shrinkage of the orbicularis muscle and septum through the transconjunctival incision enables the correction of muscle aging changes such as orbicularis hypertrophy and malar festoons. The addition of periocular resurfacing enables the correction of skin aging changes of the eyelid that are not addressed by traditional scalpel blepharoplasty. In addition, lateral canthopexy constitutes an important adjunct to the laser blepharoplasty procedure for the correction of lower lid canthal laxity.
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              Cirugía plástica reconstructiva y estética

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                Author and article information

                Journal
                oft
                Revista Cubana de Oftalmología
                Rev Cubana Oftalmol
                Editorial Ciencias Médicas (Ciudad de la Habana, , Cuba )
                0864-2176
                1561-3070
                December 2013
                : 26
                : 3
                : 390-398
                Affiliations
                [01] La Habana orgnameInstituto Cubano de Oftalmología Ramón Pando Ferrer Cuba
                Article
                S0864-21762013000300005 S0864-2176(13)02600305
                9df46ac2-8e34-4840-8f26-9e4a4d41330d

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 November 2012
                : 08 January 2013
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 9
                Product

                SciELO Cuba

                Categories
                ARTÍCULOS ORIGINALES

                láser CO2,blefaroplastia,dermatochalasis,CO2 laser,blepharoplasty

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