title: Effect of fluence on efficacy using the 1440 nm laser with CAP technology for the treatment of rhytids.
abstract: 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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Lloyd Dermatology & Laser Center, 8060 Market Street, Youngstown, Ohio 44512, USA. jrl@lloyd-derm.com
authors.forename: Jenifer R
authors.initials: JR
authors.lastname: Lloyd
mesh_terms: D000368:Aged; D004307:Dose-Response Relationship, Radiation; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007834:Lasers; D028022:Low-Level Light Therapy / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012060:Rejuvenation; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015595:Skin Aging / Q000502:physiology / Q000528:radiation effects*; D016896:Treatment Outcome