Nd:YAG 1064nm laser in the treatment of periocular veins

Background Prominent periocular veins, primarily of the lower eyelid, are a relatively frequent cosmetic problem. Although prominent periocular veins do not involve a functional problem in most of the cases, they are considered cosmetically disfiguring by many of the individuals affected and may lead to the impression of dark circles around the eyes. Reported treatment techniques include electrosurgery, sclerotherapy, and long-wavelength lasers. Objective To evaluate the long-term efficacy and safety of neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064 nm laser in the treatment of periocular veins. Patients and methods Twenty-two patients were included in this prospective and descriptive study. The patients were photographed before, immediately after the laser session, and 1 year after the treatment. The veins were treated using Nd:YAG 1064 nm laser, a 7mm spot size, 25–30 ms pulse width, and 120–130 J/cm2. The patients were followed up after 3 weeks and if the vein was still apparent, a second session was given. The photographs were evaluated by three blinded evaluators 1 year after the first session. The blinded evaluators were asked to grade the result as follows: 0= no change, 1= the vein is still present, but smaller, and 2= the vein has disappeared. The incidence of recurrence after 1 year was recorded. Results Complete clearance of the periocular veins was achieved in all the patients, with minimal incidence of side effects. All the evaluators assigned a score of 2 for all the patients they evaluated. Conclusion Laser treatment of periocular veins is one of the possible methods of treatment. The Nd:YAG 1064 nm laser is effective and safe for skin type I–IV patients. It is an excellent tool for the treatment of periocular veins.