Nd:YAG Lazer Onikomikoz Tedavisinde Etkili midir?

Amaç: Onikomikoz tırnak plağı ve subungual alanın tutulduğu bir fungal enfeksiyondur. Onikomikoz tedavisinde kullanılan topikal antifungal ajanların tedavi başarıları düşüktür. Sistemik antifungal tedavi daha etkilidir ancak hepatik ve renal toksisite riski, ilaç etkileşimleri gibi yan etkilere sahiptir. Bu çalışmamızda onikomikozlu hastaları tedavi etmek için 1064-nm long-pulsed (uzun atımlı) Nd:YAG lazerin etkinliğini değerlendirmeyi amaçladık.Araçlar ve Yöntem: Hastalığın tanısı konulmuş 25 erkek, 25 kadın toplam 50 hasta tedaviye alındı. Duetto MT EVO uzun atımlı 1064 nm Nd:YAG lazer cihazı kullanıldı. Hastalar 4 hafta arayla toplam 3 seans tedavi edildi. 4 mm uygulama genişliği, 13 milisaniye atım süresi, 1 Hz tekrarlama hızı, 40 joule/cm2 standart dozunda Nd:YAG lazer tedavisi uygulandı. Tedavi öncesi ve tedavi bitiminden 1 ay sonraki KOH pozitiflikleri istatistiksel olarak karşılaştırılarak tedavi etkinliği değerlendirildi.Bulgular: Tedaviden 1 ay sonra 4 hastada (%8) KOH testi negatif bulundu. 46 hastada (%92) ise KOH testi pozitif bulundu. Sonuç olarak tedavi sonrası KOH testi ile tedavi öncesi KOH testi pozitiflikleri arasında istatistiksel olarak anlamlı bir ilişki görülmemiştir (p=0,736). Hastalarda tedaviye ait hiçbir yan etki gözlenmedi.Sonuç: Bu çalışmada tedavi etkinliğini %8 olarak bulduk. Nd:YAG lazer’in bu parametrelerle uygulandığında onikomikoz için etkin bir tedavi seçeneği olarak kullanılamayacağı görüşündeyiz.

Anahtar Kelimeler:

KOH testi, tırnak mantarı, uzun atımlı ND:YAG lazer

Is Nd:YAG Laser Effective in the Treatment of Onychomycosis?

Purpose: The treatment of onychomycosis is low. Systemic antifungal treatment is more effective but has adverse effects such as hepatic and renal toxicity risks and drug interactions. We aimed to evaluate the effectiveness of 1064nm long-pulsed Nd:YAG laser therapy to treat patients with onychomycosis in this study.Material and Methods: 50 patients (25 males, 25 females) who were diagnosed with the disease were included in the study. A total of 50 patients, 25 were males and 25 were females. Duetto MT EVO branded which has long-pulsed and 1064 nm Nd:YAG laser device was used. Patients were treated for 3 sessions in total with 4 weeks interval. Standard dose Nd:YAG laser therapy was applied with 4 mm spot size, 13 milliseconds pulse duration, 1 Hz repetation rate, 40 joules/cm2 fluence. The treatment efficacy was evaluated by comparing the KOH positivity before and after the treatment. Results: The KOH test was negative in 4 patients (8%) after 1 month of treatment. In 46 patients (92%), the KOH test was positive. As a result, there was no statistically significant correlation between post-treatment KOH test and pre-treatment KOH test positivity (p=0,736). No side effects of treatment were observed in the patients. Conclusion: In this study, the treatment efficacy was found to be 8%. We conclude that the Nd:YAG laser cannot be used as an effective treatment option for onychomycosis when applied with these parameters.

Keywords:

KOH Test, nail fungal infection, long pulsed ND:YAG laser,

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