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Ablative laser assisted topical delivery of antifibrotics in the management of cicatricial ectropion

Ablative laser assisted topical delivery of antifibrotics in the management of cicatricial ectropion
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摘要 A variety of surgical techniques have traditionally been used to manage cicatricial ectropion. These techniques primarily aim at vertical lengthening of the anterior lamella and include a variety of skin flaps and grafts. Alternative techniques such as dermal filler injection to support the eyelid margin may also be used in the management of select patients with cicatricial ectropion. The application of different types of laser for scar revision throughout the body has rapidly evolved; similar mechanisms, principles and treatment rationale can be applied to the use of lasers in the management of cicatricial ectropion. Additionally, ablative lasers, such as Carbon Dioxide and Erbium:yttrium-aluminumgarnet lasers, may be used in the transdermal delivery of antifibrotic agents, such as interferon gamma, interferon alpha, vitamin D, triamcinolone and 5-fluorouracil, resulting in efficient target tissue penetration, limitation of systemic drug toxicity and decreased degradation. Although the combination of ablative fractional resurfacing and topical antifibrotic agents is a new treatment modality, there is a great potential for its efficient utilityin the management of periocular scarring and cicatricial ectropion. The introduction of these innovative therapeutic modalities offers ophthalmologists a greater range of possible effective treatments to address periocular scar tissue and the resultant cicatricial ectropion. A variety of surgical techniques have traditionally been used to manage cicatricial ectropion. These techniques primarily aim at vertical lengthening of the anterior lamella and include a variety of skin flaps and grafts. Alternative techniques such as dermal filler injection to support the eyelid margin may also be used in the management of select patients with cicatricial ectro-pion. The application of different types of laser for scar revision throughout the body has rapidly evolved; similar mechanisms, principles and treatment rationale can be applied to the use of lasers in the management of cicatricial ectropion. Additionally, ablative lasers, such as Carbon Dioxide and Erbium:yttrium-aluminum-garnet lasers, may be used in the transdermal delivery of antifibrotic agents, such as interferon gamma, inter-feron alpha, vitamin D, triamcinolone and 5-fluorouracil, resulting in efficient target tissue penetration, limitation of systemic drug toxicity and decreased degradation. Although the combination of ablative fractional resur-facing and topical antifibrotic agents is a new treatment modality, there is a great potential for its efficient utilityin the management of periocular scarring and cicatricial ectropion. The introduction of these innovative thera-peutic modalities offers ophthalmologists a greater range of possible effective treatments to address peri-ocular scar tissue and the resultant cicatricial ectropion.
出处 《World Journal of Ophthalmology》 2014年第2期7-13,共7页 世界眼科杂志
关键词 LASER ANTIFIBROTIC agents CICATRICIAL ectro-pion Periocular SCARRING ABLATIVE fractional RESURFACING Laser Antifibrotic agents Cicatricial ectro-pion Periocular scarring Ablative fractional resurfacing
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