Yegor Kolodchenko: Laser Treatment of Onychomycosis - 5 Years Follow-Up
The frequency of recurrence of onychomycosis is not known, recurrence rates between 6.5% and 53% have been reported, despite successful treatment with oral antifungal drugs.
1064 nm Nd:YAG laser treatment of fungal nail disease was clinically evaluated on a Ukrainian patient population. 108 patients exhibiting 312 infected nails were treated with 1064 nm Nd:YAG laser at a single clinical site over a period of two years (2010-2012). All patients were diagnosed with one of four types of onychomycosis, caused by various fungi.
At the 1 year follow-up, 89 patients (82.4%) were cured; 80 of which (74.1%) had negative fungal cultures and 9 (8.3%) showed clinical improvement, while 19 patients (17.6%) were non-responsive to the therapy.
During the 5 year period we observed recurrence in 23 cases, among them only 7 cases at late period (8-14 months). All recurrence patients were treated additionally (by laser in case of recurrence at 1-6 months and oral terbinafine at late period). Only one case of late recurrence (after 12 months) was never cured.
The last follow-up was done by the telephone interview. We could interview only 94 patients out of 108. Only 3 of the non-available patients had bad result after the treatment and 11 had good. At 5 years after the treatment 78.7% of interviewed patients remained cured and only 20 patients (21.3%) were uncured.
Thus we conclude that Nd:YAG 1064 laser treatment demonstrates good clinical result in the long term. It is safe, effective and doesn't lead to greater recurrence after 5 years than traditional oral drugs.