LAUSR

BACKGROUND The ability of simultaneous cutting and hemostasis with low lateral thermal injury makes CO2 laser a useful tool in blepharoplasty. Monopolar electrosurgery is another commonly used cutting tool that improves the quality of hemostasis and cutting speed. This study aimed to objectively and quantitatively assess the intraoperative and postoperative outcomes of transconjunctival lower blepharoplasty using either a CO2 laser or monopolar electrosurgery. METHODS Between August 2018 and March 2021, 78 patients who underwent transconjunctival lower blepharoplasty were randomly assigned to the CO2 laser group or monopolar electrosurgery group. Patient related parameters were recorded. Periorbital bruises were objectively and quantitatively assessed using the ecchymosis evaluation score. Analyses were performed using the independent sample t-test, the Mann-Whitney U test, the chi-square test, and the Fisher exact test. RESULTS Sex, age, local anesthesia injection volume, and fat removal volume were not different between the groups. Patients' subjective intraoperative heat sensation was significantly higher in the monopolar electrosurgery group than in the CO2 laser group. The CO2 laser group had a significantly lower incidence of postoperative chemosis than the monopolar electrosurgery group. All patients had uncomplicated wound healing, except three (7.89%) patients in the monopolar electrosurgery group who developed conjunctival granuloma. Operation time, intraoperative pain sensation, intraoperative blood pressure, postoperative ecchymosis, conjunctivitis, and patients' esthetic satisfaction did not differ between the groups. CONCLUSION Our findings revealed that CO2 laser is a useful technique for reducing intraoperative heat sensation and postoperative chemosis and may prevent conjunctival wound complications.