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To determine the efficacy and safety of argon laser photocoagulation of pinguecula by evaluating 1-year outcomes.Twenty-one eyes of 15 patients treated with argon laser photocoagulation (photocoagulation group) and 23 eyes of 16 patients treated with surgical excision (excision group) were retrospectively reviewed. Cosmetic outcome was evaluated by patient's self-report on a 5-grade scale (excellent, good, acceptable, poor, and very poor), and evaluation of treatment outcome was based on objective findings of anterior segment photography and anterior segment optical coherence tomography.Overall cosmetic results were excellent or good in 90.5% of laser-treated cases and 78.6% of surgically treated cases. There was no significant difference in cosmetic outcome (P = 0.15). Nineteen (90.5%) and 17 (63.9%) cases demonstrated complete removal of pingueculae after laser photocoagulation and surgical excision, respectively. The anatomic outcome was not significantly different between the 2 groups (P = 0.25). Subconjunctival hemorrhage and conjunctival scarring with an irregular surface occurred less frequently in the photocoagulation group than in the excision group [34.8% vs. 0% (P = 0.003) and 30.4% vs. 4.8% (P = 0.048), respectively].Argon laser photocoagulation is an effective and safe method for removing a pinguecula for cosmetic purposes. The method facilitates control of the extent and depth of removal and thus minimizes conjunctival defects and other complications.