Aims This study evaluates the long-term efficacy and safety of carbon dioxide (CO₂) laser excision as a novel treatment for large xanthelasma palpebrarum. Methods The study included 295 patients diagnosed with xanthelasma palpebrarum, categorised as 246 patients with grade I, 16 with grade II, 22 patients with grade III and 11 with grade IV lesions. All underwent CO₂ laser excision and were followed up for a 12-month period. Treatment efficacy was assessed through clearance and recurrence rates, evaluated using digital photography and complications were recorded. Results The participant group consisted of 66 males and 229 females, with an average age of 41.7±11.6 years. Clearance rates exceeded 99% for grades I–III and were around 95% for grade IV lesions. The recurrence rate was 6.8%, with higher recurrence rates observed in lesions over 2 mm in height compared with those under 2 mm (p<0.001). The main complications over the 12-month follow-up were scarring (4.4%), hyperpigmentation (8.1%) and hypopigmentation (8.5%), with no severe complications reported. Conclusion CO₂ laser excision emerges as a precise, minimally invasive and effective modality for treating xanthelasma palpebrarum, marking a significant advancement in treatment modalities. Further research is required to reinforce these results and refine treatment protocols. Data are available on reasonable request. The data including deidentified participant photographs are available on reasonable request (wangdq5@mail2.sysu.edu.cn).

中文翻译：

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二氧化碳激光切除术作为大眼睑黄斑瘤的新型治疗方法：长期疗效和安全性


目的 本研究评估二氧化碳 (CO2) 激光切除术作为治疗大眼睑黄斑瘤的新疗法的长期疗效和安全性。方法 纳入295例眼睑黄斑瘤患者，其中I级246例，II级16例，III级22例，IV级11例。所有患者均接受 CO2 激光切除术并随访 12 个月。通过清除率和复发率评估治疗效果，使用数码摄影进行评估并记录并发症。结果研究对象中男性66例，女性229例，平均年龄41.7±11.6岁。 I-III 级病变的清除率超过 99%，IV 级病变的清除率约为 95%。复发率为 6.8%，高度超过 2 mm 的病灶复发率高于 2 mm 以下的病灶 (p<0.001)。 12 个月随访期间的主要并发症是疤痕（4.4%）、色素沉着过度（8.1%）和色素沉着不足（8.5%），没有报告严重并发症。结论 CO2激光切除术是一种精准、微创、有效的治疗眼睑黄斑瘤的方法，标志着治疗方法的重大进步。需要进一步的研究来强化这些结果并完善治疗方案。可根据合理要求提供数据。包括未识别身份的参与者照片在内的数据可根据合理要求提供（wangdq5@mail2.sysu.edu.cn）。