ORIGINAL ARTICLE Evaluation of carbon dioxide laser therapy for benign tumors of the eyelid margin Aniko Rentka 1 & Jan Grygar 1 & Zoltan Nemes 2 & Adam Kemeny-Beke 1 Received: 10 February 2015 /Accepted: 9 August 2017 # Springer-Verlag London Ltd. 2017 Abstract Eyelid margin tumors require special attention based on both anatomical and histological perspectives. Our aim in this study was to evaluate carbon dioxide (CO 2 ) laser therapy for the treatment of eyelid margin tumors. Fifty-two patients with 55 eyelid margin tumors were included in this study. All tumors were removed with a CO 2 laser, and histopathological evaluation was obtained in 52 cases. All patients were followed up for a mean period of 8.5 months (range 6 to 14 months). There were no bleedings in the intra- and postoperative period; the wounds were dry and reepithelized after 10–14 days and no recurrence occurred during follow-up period. Compared to the surrounding tissue, the treated area was hypopigmented and maximum five eyelashes (average 2.5) were wasted during the procedure. We achieved com- plete patient and surgeon satisfaction with cosmetic and therapeutic results. CO 2 laser treatment of eyelid margin is a safe and effective procedure; its cosmetic result is beneficial as it does not cause malposition of the eyelid or damage to the lacrimal drainage system if the tumor is located in its proximity. Keywords Carbon dioxide laser . Laser surgery . Eyelid margin . Benign tumor . Complication Introduction The most frequent form of treatment of eyelid tumors is man- ually performed surgical excision. However, treatment of the eyelid margin presents some specific surgical difficulties which need to be considered. A wide range of techniques is available for their management, such as cryotherapy, electrocauterization, chemical cauterization using trichloro- acetic acid (TCA) or bichloroacetic acid, and laser treatment [1–5]. Periocular laser surgery has been continuously gaining in popularity [6]. To date, multiple types of laser devices emitting differ- ent beam wavelengths have been used to treat the eyelid and the anterior segment: argon-laser (Ar, 488–514 nm) [ 1], erbium yttrium aluminum garnet laser (Er:YAG, 2790–2940 nm) [7, 8], erbium yttrium scandium garnet laser (Er:YSSG, 2790 nm) [9–11], and carbon dioxide laser with infrared source (CO 2 , 10,600 nm) [4, 12–14]. Laser eyelid surgery has become popular mostly due to the introduction of new-generation technical improve- ments such as pencil-shaped handpieces for use in bleph- aroplasty and cutaneous resurfacing. Laser therapy is ef- fective in the treatment of eyelid tumors as well. Conventional CO 2 lasers and Er:YAG lasers are currently considered to be the gold standard for eyelid surgery [9, 15]. The available working modes of CO 2 lasers are the continuous flash-scanning mode, pulsed mode, and most recently, the ultrapulsed mode. There are three basic types of interaction between laser and tissue: photocoagulation, photodisruption, and photoablation [10]. The clinically most utilized of these is photoablation. The 10,600 nm wavelength peak of the CO 2 laser beam is absorbed by water, the main component of soft tissues. This causes a steep rise in temperature, far beyond 100 °C, which results in evaporation of intracellular water. This heating * Adam Kemeny-Beke kemenyba@med.unideb.hu 1 Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Nagyerdei krt 98, Debrecen 4032, Hungary 2 Department of Pathology, Faculty of Medicine, University of Debrecen, Nagyerdei krt 98, Debrecen 4032, Hungary Lasers Med Sci DOI 10.1007/s10103-017-2309-4