RESUMO
In this brief review we will discuss the reasoning and evolution of our current use of combined very high-fluence collagen crosslinking and laser in situ keratomileusis. Several presentations and pertinent publications are reviewed, along with the key steps of the enhanced LASIK procedure. Long term outcome data support the safety and efficacy of LASIK Xtra in stabilizing myopic but also hyperopic LASIK results. In conclusion, we have compelling evidence that LASIK Xtra is a safe and effective adjunct.
RESUMO
BACKGROUND: Viral warts are benign epithelial proliferations induced by the human papillomavirus (HPV) and they affect 7~10% of the population. Some warts such as periungual warts are resistant to various treatment modalities, including cryotherapy, surgical excision, carbon dioxide laser therapy and immune therapy. Thus, some studies have reported that pulsed dye laser has been effectively used for treating recalcitrant warts. OBJECTIVE: The purpose of this study was to evaluate the therapeutic response and safety of pulsed dye laser using high fluence for the treatment of periungual warts. METHODS: 66 periungual warts on 28 patients were treated with pulsed dye laser. The treatment parameters were a spot size of 5.0 mm, a pulse duration of 0.45~1.5 ms and a fluence of 14.0~15.0 J/cm2. The warts were evaluated at 2~3 week intervals to assess the clearance rate and side effects. RESULTS: Complete clearance was achieved for 47 out of 66 periungual warts (71.2%). The average number of treatment sessions was 2 (range: 1~6). After the first session, complete clearance was achieved for 24 out of 66 warts (36.4%). No significant side effects were observed except for pain during and after the procedure. During a median follow up period of 7 months (range: 3~15 months), 10 periungual warts on 3 patients recurred. CONCLUSION: Pulsed dye laser using high fluence could be used as a safe and successful treatment for recalcitrant periungual warts.