Plasma-based technologies are increasingly gaining traction as safe, precise, and minimally invasive tools in oculoplastic and periocular surgery. This systematic review explores their efficacy, safety, and clinical applications across esthetic and therapeutic domains. A comprehensive search of PubMed, Scopus, EMBASE, Web of Science, and the Cochrane Library identified 245 articles published between January 2010 and December 2025. After screening and eligibility assessment, 25 clinical studies were included in the qualitative synthesis. Devices evaluated included plasma exeresis, plexr, cold atmospheric plasma, PANIS, nonthermal atmospheric-pressure plasma, helium plasma (J-Plasma), and voltaic arc plasma. These technologies were applied to indications such as benign eyelid lesions, xanthelasma, dermatochalasis, conjunctivochalasis, and periorbital rejuvenation. Across studies, plasma-assisted procedures showed high efficacy in lesion resolution and cosmetic improvement, with reported success rates exceeding 90% in many cohorts. Downtime was minimal, and adverse effects, limited to transient erythema, edema, or crusting, were infrequent and self-limiting. No significant complications were reported. Due to heterogeneity in study design, outcome metrics, and device settings, meta-analysis was not feasible, and findings were synthesized narratively. Despite limitations, current evidence supports plasma-based modalities as effective adjuncts or alternatives to traditional surgical approaches, especially in patients seeking nonexcisional solutions with faster recovery. Recent innovations such as helium plasma resurfacing, exosome integration, and customizable energy delivery further enhance their potential. Larger, standardized, and comparative trials are needed to optimize protocols and validate long-term safety and outcomes.
Yadav et al. (2026) studied this question.