Yellow Laser Photocoagulation of Deep Conjunctival Nevus: A Minimally Invasive Technique

Abstract

Purpose

To evaluate the safety and efficacy of yellow laser photocoagulation for deep conjunctival nevi.

Methodology

This prospective interventional case series included patients with clinically stable conjunctival nevi for ≥6 months. Treatment was performed using the Iridex yellow laser (577 nm) under topical anesthesia, with a 200-micron spot, 80 ms exposure, and 300–600 mW power. The lesion was removed with sterile cotton buds post-laser, and topical steroids were prescribed for one week. Follow-up was at day 1, week 1, month 1, and month 3, assessing ocular surface health and lesion resolution. Examinations included Schirmer Test 1, Oxford corneal staining, Ocular Surface Disease Index (OSDI), tear meniscus height, and non-invasive keratograph break-up time (NIKBUT).

Results

The study included 10 eyes from 9 patients. Mean age was 30 years (range: 6–63), with a 1:1 sex ratio. Anterior segment OCT confirmed subepithelial lesions in all, with intralesional cysts in 60%. Mean nevus diameter was 4.2 mm (range: 2–11), and 70% showed severe pigmentation. Laser treatment was completed in one session for 90% of eyes; one required a second due to large size. No significant changes were observed in ocular surface parameters. At a mean follow-up of 10.5 months (range: 3–17), 85% (6/7) of eyes had complete resolution when the laser was fully applied. No recurrence occurred. One patient developed conjunctival scarring from inadvertent Tenon's capsule application.

Conclusion

Yellow laser photocoagulation is a safe, effective, minimally invasive outpatient treatment for conjunctival nevi, including deeply pigmented cases. It yields excellent cosmetic outcomes with minimal side effects, supporting its role as a potential standard of care.