Corneal epithelium removal during photorefractive keratotomy (PRK), TransPRK, or corneal cross-linking (CXL) means that patients experience pain and inflammation after the procedure, which need to be carefully managed with topical drug regimens. One highly effective class of topical analgesics is non-steroidal anti-inflammatory drugs (NSAIDs), but these must be used carefully, as their use has been associated with delayed re-epithelialization and, in rare cases, corneal melting. However, our clinical experience has been that the concomitant use of topical corticosteroids obviates this risk. Here, we present a mechanistic explanation for our observations, our TransPRK and epithelium-off CXL protocols, and the postoperative medication regimens where topical NSAIDs are used in combination with topical steroid therapy during the first two postoperative days (where pain and inflammation levels are the highest). We detail the results of a single-center retrospective case analysis that examined eyes that underwent TransPRK (n = 301) or epithelium-off CXL (n = 576). Topical NSAID use in the first two postoperative days to control pain and inflammation after PRK/TransPRK or epithelium-off CXL, when used in combination with topical steroid therapy, does not appear to be associated with corneal melting or delayed epithelial healing. This approach may represent an improvement over current methods of handling post-surgical pain in procedures that require corneal epithelial debridement.

OBJECTIVE: To compare the efficacy of three surgically assisted permanent anterior tooth eruption methods (laser surgery, electrosurgery and routine surgery) in children.
METHODS: Sixty-three orthodontic children with retarded permanent anterior tooth were selected and according to the random number table divided into three groups: laser surgery group (group A), electrosurgery group (group B) and routine surgery group (group C). The total operative time (min), the duration of pain after gingival excision (d), Visual Analogue Scale (VAS) pain intensity scores (0-10 cm), and gingival healing time (d) were all recorded. Six months after treatment, periodontal indexes of the three groups, including gingival indexes (GI), plaque indexes (PLI), probing depth (PD) were checked by the same periodontist and recorded.
RESULTS: Surgical records showed that compared with group C, there were statistically significant differences in operative time, pain duration, pain intensity and healing time in group A and B (P < 0.05). There was no significant difference in these four results between group A and group B. Periodontal examination indicators 6 months after surgery showed no statistical differences in GI, PLI and PD among group A, B and C. Oral clinical examination found that the three groups of patients with different treatment, dental eruption was normal.
CONCLUSIONS: All the three treatments can effectively solve the problem of delayed eruption of permanent anterior teeth in children. Particularly, laser surgery and high-frequency electrosurgery have good efficacy, little pain and high operability, which can be considered as a better method to aid teeth eruption.

The effects of general anesthetics on cognitive impairment are unclear and complicated. Laser laryngeal surgery (LLS) requires the administration of low levels of oxygen, which may increase the risk of desaturation and brain function impairment. This prospective randomized trial aimed to compare the effects of desflurane and propofol-based general anesthesia on the occurrence of early postoperative cognitive decline in elderly patients undergoing LLS.
Seventy-three patients classified as American Society of Anesthesiologists grade I or II and at least 65 years of age were randomly allocated to receive either desflurane-based (Group D) or propofol-based (Group P) anesthesia during LLS. The standard anesthesia protocol was performed, with a bispectral index between 40 and 60 and a mean arterial pressure within 20% of baseline values. Intraoperative regional oxygen saturation values were recorded. Each patient was assessed using the mini-mental state examination (MMSE) test during the preoperative period (baseline), 30 min after extubation in the postanesthesia care unit, and 1, 3, and 24 h after surgery.
MMSE scores improved slightly in both groups compared to baseline during the early postoperative period, but these increases were not statistically significant. No significant differences were identified in MMSE scores between groups. Only three patients (9.6%) in group D and one patient (3.1%) in group P developed cognitive impairment (p = 0.583).
Low intraoperative inspired oxygen concentration during short-duration LLS did not reduce early postoperative cognitive function in elderly patients. Desflurane or propofol-based anesthesia had similar effects on early neurocognition after LLS.
2 Laryngoscope, 133:640-646, 2023.

OBJECTIVE: The objective of this study is to compare the overall survival (OS) and the cancer-specific survival (CSS) for patients of T1aN0M0 glottic cancer who underwent laser surgery (LS) or radiation (RT).
METHODS: The data of the population-based analysis were extracted from the SEER database. The studies of the meta-analysis were identified through PubMed, EMBASE, and Cochrane databases. Cox regression analyses, the propensity score analysis (PSM), survival analyses, and the meta-analysis were performed.
RESULTS: In the population-based analysis, 2101 eligible patients were included. Multivariable Cox analyses indicated that patients accepting LS alone would obtain better OS (HR 0.77, 95% CI 0.61-0.98, p = 0.03) and CSS (HR 0.26, 95% CI 0.12-0.59, p = 0.001) than those of whom they accepted RT alone. Survival analyses before PSM and after PSM also indicated that patients who underwent LS alone would have better OS and CSS. In the meta-analysis, nine eligible studies were included. Results of the pooled effect showed that significant differences existed between LS and RT groups on OS (OR: 1.84, 95% CI 1.36-2.50, p < 0.001) and CSS (OR 3.84, 95% CI 1.17-12.52, p = 0.026), both distinctly favoring LS.
CONCLUSIONS: Compared with RT, LS may acquire better survivals for patients with T1aN0M0 glottic cancer. Simultaneously, more multi-center randomized controlled trials would be warranted to prove the conclusion.

OBJECTIVE: To determine the efficacy and safety of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) in cervical intraepithelial neoplasia (CIN) infected by HPV.
METHODS: The clinical data of 115 patients with HPV-Infected CIN admitted to our hospital were selected for this retrospective analysis. They were divided into a control group (n=53) and an experimental group (n=62) according to different treatment methods. Patients in the control group were treated by laser therapy, while those in the experimental group were treated by ALA-PDT. The two cohorts of patients were compared with respect to clinical efficacy, LSIL cure rate, adverse reactions, and complications. Patients were followed up for 3 months and 6 months, and their clinical outcomes were compared based on HPV persistence and residual/recurrent low-grade squamous intraepithelial lesion (LSIL). In the experimental group, the negative conversion rate of HPV and the degree of squamous epithelial lesions in patients with different HPV infection types and various visible degrees of transformation zones (TZs) were compared 6 months after surgery.
RESULTS: After 6 months of follow-up, the HPV clearance rate and LSIL reversal rate in the control group were 62.3% and 64.2%, respectively, while those in the experimental group were 79.0% and 80.6%, respectively, with significant differences between the two groups (P<0.05). There was no significant difference between the two groups in terms of the LSIL cure rate of lesions located in cervicovaginal region and cervicovaginal region + cervical canal (P>0.05). Neither were there any significant differences in HPV negative conversion rate and LSIL residual/recurrence rate in patients with HPV 16/18 and non-HPV 16/18 between the control group and the experimental group (P>0.05). However, the HPV negative conversion rate in partially visible TZs was lower than that in completely visible TZs, and the LSIL residual/recurrence rate in the completely visible TZs in the control group was higher than that in the experimental group (P<0.05). The incidence of adverse reactions was not significantly different between the two groups (P>0.05), but the incidence of complications in the control group was higher than that in the experimental group (P<0.05). Neither the experimental group nor the control group had any cases of pathologic escalation to high-grade squamous intraepithelial lesion (HSIL).
CONCLUSIONS: ALA-PDT can effectively treat HPV-infected CIN and promote HPV clearance.

Surgical treatment of eyelid margin lesions is challenging, and few studies focused on laser therapy of such type of lesions. To evaluate the safety and effectiveness of ultrapulse CO2 laser treatment under a microscope for benign eyelid margin lesions, we performed microscopic ultrapulse CO2 laser treatment win 132 patients with benign eyelid margin lesions for cosmetic reasons. Measurements included cosmetic results, complications and patients\' satisfaction. Eighty lesions involved the gray line and 24 lesions were in the lacrimal region. All patients achieved satisfactory cosmetic and therapeutic outcomes. Eyelid contour recovered well with no scar and no malposition. No secondary epiphora was noted after the lesions adjacent to the lacrimal punctum were removed. At the end of follow-up, only 2 patients had mild hypopigmentation and only 1 patient required repeat laser therapy for recurrence. It turned out that ultrapulse CO2 laser treatment under a microscope is a dependable, safe, and effective method for the treatment of benign eyelid margin lesions. It is an excellent alternative to traditional surgery, especially for lesions involving the gray line or positioned in proximity to the lacrimal punctum. It is beneficial for simplifying the treatment, improving the cosmetic result, and maintaining eyelid function.

Manipulation and precise delivery of optical energies in the regions of interest within specimens require different strategies. Hence, proper control of input beam parameters is a prerequisite. One of the prominent methods is metasurface optics, capable of crafting properties of light at nanoscales. Here, the generation of an abrupt autofocusing (AAF) beam by a nanophotonic metasurface for biomedical applications is demonstrated. Fluorescence guided laser microprofiling of mouse cardiac samples is experimentally investigated, using the AAF beam to deliver optical energy selectively to specific locations. In addition, photocoagulation of ex vivo swine skin tissue is performed and observed through optical coherence tomography. The results show great potentials for integrating metasurface optics to realize miniature laser surgery instruments for wide applications in biomedicine.

BACKGROUND: To compare the long-term effect after modified CO2 laser-assisted sclerectomy surgery (MCLASS) and conventional trabeculectomy (TRAB) in medically uncontrolled Chinese primary open-angle glaucoma (POAG) patients. This was a retrospective comparative study.
METHODS: A total of 87 patients were reviewed, including 45 in the MCLASS group and 42 in the TRAB group. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and use of supplemental medical therapy were retrospectively compared at baseline, and until 36 months postoperatively.
RESULTS: Patients in both groups achieved a significant IOP decrease from baseline (P < 0.001); postoperative IOP in the MCLASS group was significantly lower than that in the TRAB group at 24 and 36 months. The reduced use of medication was statistically significant in both groups, and the number of postoperative medications was significantly more in TRAB group at 24 and 36 months. At 24 and 36 months, the complete success rate was 60% and 53.3% for MCLASS versus 66.7% and 59.5% for TRAB, and the qualified success rate was 91.1% and 88.9% for MCLASS versus 83.3% and 80.9% for TRAB, respectively. BCVA deterioration post TRAB was clinically more serious than that post MCLASS at 24 and 36 months, although the difference was not statically significant at any time point postoperatively. Compared with MCLASS, more complications occurred postoperatively in the TRAB group.
CONCLUSIONS: MCLASS is an effective surgical option for Chinese POAG patients. Compared to TRAB, eyes undergoing MCLASS experience a comparable success rate, a greater IOP reduction, fewer medications, and a lower risk of complications up to 36 months.

OBJECTIVE: Precise control of the thermal damage is critical during thermal therapy with the assistance of gold nanoparticles, which depends on the laser parameters and characteristics of gold nanoparticles. However, the current understanding of the relationship between the gold nanoparticles/incident laser light and the efficiency of photothermal therapy is limited, which should be studied systematically.
METHODS: In this study, theoretical simulations were conducted to investigate the influence of laser wavelength, the size and shape of gold nanoparticles, and the distance of the particle in complex nanostructures on the optical properties and temperature distribution after laser irradiation, aiming to achieve maximum photothermal conversion efficiency and therapeutic effect during the laser treatment of port wine stains. Thereafter, gold nanoparticles were prepared and in vivo experiments were conducted to evaluate the effect on thermal damage of blood vessels.
RESULTS: For the laser wavelength at 532 nm, gold nanospheres with diameters of 20 nm are ideal in terms of temperature rise. The optimized particle distance is 5 nm and the corresponding concentration is 0.26 mg/ml. For Nd:YAG laser at 1064 nm, gold nanorods with an aspect ratio of 6.3 and an effective radius of 12.7 nm are the most effective photothermal agents. The optimized particle distance is 4 nm, yielding the optimal concentration of 0.017 mg/ml. In vivo results demonstrated that using gold nanoparticles following our simulations as photothermal agents can greatly enhance the thermal damage of diseased blood vessels, reducing the laser energy and laser pulses required for the obvious thermal response of blood vessels.
CONCLUSIONS: For different laser wavelengths used in clinics in the near future, theoretical models presented in this study can be employed to obtain the morphology of single gold nanoparticle and the concentration of nanoparticles solutions, thereby obtaining the optimal photothermal conversion and enhanced thermal damage assisted by gold nanoparticles.

Vascular epulis is a rare clinical disease. In our study, a case of vascular epulis in the cosmetic area was treated by diode laser, without recurrence and obvious inflammation in the surgical site 5 years after surgery. This case report indicates that the excision of vascular epulis in the cosmetic area of the anterior teeth by diode laser could be an alternatively safe and complementary approach in lieu of conventional surgery.