Prospective comparison treatment of 595-nm pulsed-dye lasers for virgin port-wine stain.

Background: Vbeam(®) and Cynergy(®) are 595-nm pulsed-dye laser (PDL) equipment options, both extensively used in the clinical treatment of port-wine stains (PWS). However, there has been no study conducted of the differences in PWS therapeutic outcomes across both devices.

Objective: To compare the efficacy and safety of Vbeam and Cynergy equipment in the treatment of PWS.

Methods: Twenty-two patients with PWS were included in this study and were treated with both Vbeam and Cynergy. Patients underwent three treatment sessions. Treatment parameters used were as follows: (i) Cynergy(®) , Cynosure Corp., 595-nm wavelength, radiant exposure of 11 J cm(-2) , 2-ms pulse duration, 7-mm spot size, cold-air cooling system of level 3. (ii) Vbeam(®) , Candela Corp., 595-nm wavelength, radiant exposure of 11 J cm(-2) , 1·5-ms pulse duration, 7-mm spot size, cryogen spray cooling (30 ms of cooling with a 20-ms delay). Clinical efficacy outcomes were evaluated by chromameter and visual assessment 2 months post-treatment.

Results: All patients were treated by both Vbeam and Cynergy on adjacent sites. Chromameter evaluation showed that the average blanching rate was 21·24% for Cynergy sites and 36·42% for Vbeam sites. This difference was statistically significant (P = 0·05), which suggests that PWS respond better to Vbeam than to Cynergy at the settings used in this study. No patients developed scarring or permanent pigmentation change.

Conclusions: Compared with Cynergy, Vbeam may be more effective in the treatment of PWS. Despite using supposedly equivalent fluences in 595-nm PDLs, equivalent clinical results cannot be guaranteed.