Introduction  

Ocular cryotherapy is a technique that uses freezing to treat various eye and eyelid problems.  Some of the eye conditions include:

  • Trichiasis - The inward growth of eyelashes. It can arise from an eye injury, infection, constant rubbing of the eye, or aging.
     
  • Glaucoma - An eye disorder characterized by a buildup of fluid at the eye's front. It is mainly a hereditary disease but may also result from blockage of blood vessels, inflammation, and severe infections.
     
  • Retinal detachment - An eye problem mainly caused by eye injury or advancement in age where the retina pulls away from its usual position.
     
  • Retinoblastoma - A type of eye cancer that commonly affects the retina in children.

 

In 1933, Bietti performed the first ocular cryotherapy. His technique entailed cooling a metal probe in a mixture of acetone and carbon dioxide and then using it to close a retinal hole. As an improvement to Bietti's technique, Deutschmann later developed the use of dry ice probes, in place of the metal ones.

The techniques remained dormant in the ophthalmology field until 1961, when Krwawicz developed a cataract extraction technique. His approach, together with advancements from other pioneers, has since popularized cryotherapy for a variety of eye conditions.
 

Also Known As

  • Cryoablation
  • Cryocautery
  • Cryosurgery

 

Preparation & Expectation Before Surgery

The procedure requires minimal preparation. Before treatment, patients may need to inform the doctor of their medical history. It would be essential to notify the doctor of any allergies or medical reactions. The doctor may also require that a patient stops some medication weeks before surgery.

Patients should organize to have someone to help them get home due to eye patching or blurred vision that may accompany treatment.

As an outpatient procedure, patients should expect to go home on the same day.
 

Types, Purpose & Procedure

Exclusive of cataract extraction, cryotherapy is commonly a surface procedure that entails no incisions. It may involve the use of any among the four available types of cryogens, namely; nitrous oxide, solid carbon dioxide (dry ice), Freon, and liquid nitrogen. Liquid nitrogen ranks as the most effective due to its extremely low boiling point which enables rapid freezing.

The procedure aims at treating eye conditions which, if left unattended, would threaten vision. It is applied in several eye treatments, and it works to:

  • Extract cataracts - The cataracts are frozen and removed to enable passage of light.
     
  • Repair tears and holes in the retina - When cryogen is introduced, cells die, and scars form due to the low temperatures. As a result, the edges of the eye become sealed.
     
  • Reduce intraocular pressure in advanced glaucoma - The freezing destroys part of the aqueous producing organ, thus preventing further fluid production.
     
  • Remove ingrown lashes - Cryogen freezes and destroys the hair follicles hence inhibiting further growth of annoying lashes.

 

The procedure takes approximately 30 minutes and involves the following steps:

  • The doctor measures the patient's eye
     
  • The patient receives eye drops and local anesthesia that numb the eye
     
  • Through the eye's exterior surface, the doctor inserts a cryoprobe that directs cryogen to the problem area. The cold gases freeze and destroy damaged cells and tissues. Under local anesthesia, the patient will remain awake throughout the process.

 

Risks, Side Effects & Complications

The procedure may result in eye redness, swelling, and retinal bleeding. In the treatment of trichiasis, there may be damaging risks to the surrounding tissue.

The possible side effects include:

  • Blurry vision expected to clear in a few days
  • Slight pain
  • Eye dryness
  • Sensitivity to light

 

Cryotherapy complications could be linked to inexperience or over freezing. Among the complications are depigmentation, loss of eyelashes, or the eye problem's recurrence in the long term.

One should seek further treatment in case of vision change, worsening pain, and severe redness or swelling.
 

After Care, Recovery & Outcome

Home care routines may entail:

  • Use of cold compresses to relieve swelling and discomfort
     
  • Minimal physical activities to facilitate healing
     
  • Eye drops to reduce redness
     
  • Wearing sunglasses to protect the eye, especially after cataract removal

 

While one can resume normal activities immediately, full recovery may take approximately three to six weeks.

Cryotherapy provides effective outcomes in eye problems diagnosed early, while severe eye damages may require additional treatment.