Is Q-switched neodymium-doped yttrium aluminium garnet laser an effective approach to treat xanthelasma palpebrarum? Results from a clinical study of 76 cases.

BACKGROUND Treating xanthelasma palpebrarum may prove difficult because of its delicate location on the eyelid. Various forms of nonablative laser techniques have been examined, and Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser therapy has shown promising preliminary results. OBJECTIVES To determine the efficacy of Q-switched Nd:YAG laser treatment for xanthelasma removal. MATERIALS AND METHODS Thirty-seven consecutive patients with 76 lesions received two treatment sessions with a Q-switched Nd:YAG laser without local anesthesia (6 J/cm(2) [1,064 nm] or 2 J/cm(2) [532 nm], 4-mm spot size, 2-3 passes). Photographs were taken before each treatment session and 4 weeks after the second treatment. Two independent examiners rated clearance in four groups (none [<25% cleared], moderate [25-50%], good [51-75%], and excellent [>75%]). RESULTS Only two-thirds of the patients completed the entire course of the study; disappointing early results were the main reason for dropping out. The majority of treated lesions (70% or 75%, depending on the examiner) showed no clearance. Plasma low-density lipoprotein cholesterol levels displayed some influence on treatment results but not enough to facilitate stratification of patients. CONCLUSION Q-switched Nd:YAG (532 nm and 1,064 nm) laser treatment of xanthelasma cannot be recommended.