Table 1 Summary of studies included in the review
From: The effectiveness of lasers in the treatment of onychomycosis: a systematic review
Author(s) | Study type | N of subjects (Nails) (Fingernails)* | Laser | Diagnostic criteria | Max. follow up period | Study endpoint |
|---|---|---|---|---|---|---|
Carney et al. [26] | Case Series | 10 (18) | 1064 nm Nd:YAG (short Pulse). 1 treatment. | Culture | 24 weeks | Decrease in area of nail visually affected measured with the Onychomycosis Severity Index (OSI) and negative cultures. |
Hees et al. [37] | Comparative study | 10 (20) | 1064 nm (long v. short pulse) on each hallux 2 treatments over 4 weeks (side by side comparison). | Histology | 36 weeks | Decrease in area of nail visually affected measured with the Onychomycosis Severity Index (OSI). Negative histology & cultures. |
Hochman [28] | Case Series | 8 (12) (1)* | 1064 nm (short pulse). 2 or 3 treatments, 3 weeks apart. | Culture or PAS | 24 weeks | Negative fungal cultures. |
Hollmig et al. [29] | RCT | 27 (125) | 1064 Nd:YAG. 2 Treatments 2 weeks apart versus control. | Culture or PAS | 52 weeks | Negative cultures and measured clearance at 3 months for all subjects, and repeated clearance measurement at 12 months for those treated with laser. |
Kalokasidis et al. [30] | Case Series | 131 (unknown) | 1064 nm/532 Q switched Nd:YAG. 2 treatments, 30 days apart. | Microscopy & Culture | 12 weeks | Decrease in area of nail visually affected measured with the Onychomycosis Severity Index (OSI) and negative cultures. |
Kimura et al. [31] | Case Series | 13 (37) | Nd:YAG 1064 nm (long Pulse) 2–3 treatments, 4 weeks apart. | Microscopy | Up to 24 weeks | Improvements in nail turbidity score and, negative culture if nail was 100% improved in turbidity score. |
Landsman et al. [25] | RCT | 36 (37) | 870 nm/930 nm laser or sham control device. 4 treatments over 60 days. | Culture or PAS | 24 weeks | Decrease in affected nail area (clearance) and negative culture or PAS stain. |
Lim et al. [32] | Case Series | 24 (unknown) | CO2 laser. 3 treatments at 4 weeks plus topical treatment. | Microscopy | 24 weeks | Decrease in affected nail surface area and negative microscopy. |
Moon et al. [33] | Case Series | 13 (43) (12)* | 1064 nm Nd:YAG (long pulse). 5 treatments at 4 week intervals. | Microscopy & Culture | 24 weeks | Decrease in affected nail surface area and negative microscopy. |
Noguichi et al. [34] | Case Series | 12 (12) | 1064 nm Nd:YAG (long Pulse) 3 treatments at 4 week intervals. | Microscopy or PCR or culture | 24 weeks | Decrease in nail surface area affected and negative microscopy. |
Waibel et al. [35] | Comparative study | 21 (21) | 1064 nm ND:YAG v. 1319 nm v. Broadband light. 4 treatments at one week apart. | Culture & PAS | 24 weeks | Negative fungal culture. |
Zhang et al. [36] | Comparative study | 33 (154) (18)* | 1064 nm Nd:YAG (long pulse) Either 4 OR 8 treatments - one week apart. | Microscopy & Culture | 24 weeks | Negative culture and measured decrease in affected nail surface area. |