Table 1.
Summary of studies included in the 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. |