Effect of fluence on efficacy using the 1440 nm laser with CAP technology for the treatment of rhytids.

Background And Objective: The objective of this study was to evaluate the effect of fluence on the treatment of rhytids using a 1440 nm laser with CAP(SM) technology and the T350 tip.

Study Design/materials And Methods: Twelve subjects with rhytids were enrolled in an IRB approved study. The Affirm laser with CAP technology (Cynosure, Inc., Westford, MA) 1440 nm, 10 mm T350, 2 milliseconds, 1.5 Hz was used at fluences ranging from 3.0 to 5.5 J/cm(2) in a split face study. At each treatment visit, fluences on the right side of the face were held constant at 3.0 J/cm(2), while the left side of the face started at 3.0 J/cm(2) and increased 0.5 J/cm(2) with each treatment to a maximum of 5.5 J/cm(2). Five treatments were given at 2-week intervals using the SmartCool (Cynosure, Inc.). Photographic comparisons at baseline and 3 months were used to compare fluence results as well as to evaluate for efficacy in the treatment of rhytids. The following standard scale was employed: Poor (0-25%), Fair (26-50%), Good (51-75%), and Excellent (76-100%). In addition, following the study, a few subjects received a series of laser pulses at increasing fluences on their buttocks to further evaluate the effect of fluence on tissue reaction.

Results: Comparing the right and left photographic results, no clinically observable differences were noted. Both sides received the same grade in all cases. Five subjects (42%) were noted to have Good results, three (25%) were given a rating of Fair, and four (33%) were given a Poor result with little or no improvement observed. The follow-up buttock fluence study demonstrated an effect threshold at 3.0 J/cm(2).

Conclusion: The 1440 nm laser with CAP technology can provide overall improvement in patients with rhytids at moderate fluences. Increasing the fluence does not appear to increase efficacy.