There are many research presentations on removing or treating many skin diseases using lasers [8]. However, the eyelids, especially benign tumors or illnesses in the margin of the eyelid (the boundary between the eyeball and the skin), are unfamiliar areas to dermatologists. On the other hand, most ophthalmologists are easily accessible to ocular lasers as pan-retinal photocoagulation (PRP) or refractive surgery, but most are not familiar with eyelid laser irradiation. Therefore, many oculoplastic surgeons primarily perform excision biopsies [12, 13].
In this study, we demonstrated that laser ablation is an effective and well-tolerated alternative therapeutic modality in the treatment of benign eyelid lesions. The 577 nm wavelength yellow laser has peak absorption in oxyhemoglobin and is minimally absorbed by xanthophyll, melanin and H2O [14]. With this characteristic of 577 nm wavelength, many advantages have been reported in the treatment of vascular diseases (Port wine stain, telangiectasia, etc.) in dermatology [15, 16] and various other diseases (Demodex, inflammatory acne, etc.) [17, 18] as being applied. When irradiating the retina, the lower absorption and increased transmission of 577 nm through the non-uniform melanin granules of the RPE are more than compensated by the higher absorption of 577 nm in the underlying more uniformly distributed hemoglobin-rich choriocapillaris. It allows treatment closer to the fovea. Therefore, there are many research results on diseases such as diabetic macular edema and CSC [19, 20] When applied to the skin, the selective photothermolysis system targets the lesion specifically without causing thermal damage to surrounding tissue, which helps to avoid scarring and dyspigmentation [16].
There are several preparations for laser treatment. Even if lidocaine cream is sufficiently applied, some pain remains, so that most patients can feel pain. If the pain is very severe and it is difficult to use laser treatment, a local lidocaine anesthetic injection can be performed. It is also recommended to wear a plastic cornea protector to prevent laser exposure to the eyes.
The fact that epithelialization progressed slightly faster in the laser group is likely due to the smaller average lesion size. Laser ablation itself cannot explain that epithelialization is faster than surgical excision. This part is one of the limitations of the study. Another limitation is that the lesion size affected the treatment method when the physician chose the initial treatment option, so there may be selection bias for this result.
In conclusion, it can be an effective alternative to the surgical approach in treating tumors of small eyelid margins using a laser. In addition, it provides an opportunity to choose a suitable treatment option for patients who are reluctant to surgical removal of lesions on the eyelid margin. In particular, for lesions that are small in size and not deep, rapid treatment effects and cosmetic satisfaction may be high.