Intralesional diode laser pretreatment facilitates surgery for orbital venous malformations: initial experience with 23 consecutive patients

Graefes Arch Clin Exp Ophthalmol. 2022 Jan;260(1):303-309. doi: 10.1007/s00417-021-05272-3. Epub 2021 Aug 11.

Abstract

Purpose: This study aims to evaluate the efficacy and safety of intralesional diode laser pretreatment for facilitating surgery for orbital venous malformations (OVMs).

Methods: This is a retrospective, non-comparative, interventional cohort involving 23 consecutive OVM patients undergoing intralesional laser pretreatment followed by surgical excision. The main outcome measures included volumetric changes, exophthalmometry, cosmesis, and symptom scores as well as treatment-related adverse events.

Results: Following intralesional diode laser, the mean volume dropped significantly from 2366 ± 1887 to 129 ± 119 mm3 (t = 5.716; p < 0.001). After a single treatment session, a mean 90 ± 13% volume shrinkage was achieved in all 23 OVM. The mean Hertel exophthalmometry decreased significantly from 14 ± 3 to 13 ± 1 mm (t = 2.515; P < 0.02). The resolution of periocular dyschromasia and swelling were evident in 20 patients (87%). Symptom scores improved significantly from 6.5 ± 1.4 (very intense discomfort or effect on daily living) to 1.2 ± 1.0 (very mild discomfort or effect on daily living; p < 0.001). Short-term bruises and swelling were reported in 20 patients (87%).

Conclusion: Intralesional laser pretreatment is effective to facilitate surgery especially for the deep involving orbital venous malformations.

Keywords: Distensible lesion; Intralesional diode laser pretreatment; Orbital venous malformations (OVMs); Surgical removal.

MeSH terms

  • Humans
  • Injections, Intralesional
  • Lasers, Semiconductor* / therapeutic use
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Malformations* / diagnosis
  • Vascular Malformations* / drug therapy
  • Vascular Malformations* / surgery
  • Veins / surgery