Cryotherapy

cryotherapy in ophthalmology

1. CRYOTHERAPY

2. INTRODUCTION
•Different methods to create chorioretinal
adhesion.
•Adhesion produced by all treatment is
between the retina and pigment epithelium,
but referred to as chorioretinal adhesion.

3. CRYOTHERAPY
•Scholer; Freezing creates inflammation in
the area of application.
•Linde instrument employed CO2 or N2O
as cryogenic agents.
•Works on Joule-Thompson principal.

4. Effects on the tissue
•Cryo causes dissolution of cellular
membrane.Intracellular ice causes
mechanical damage with rupture of
cellular membrane.
•Strength of adhesion between retina and
RPE is proprotional to the intensity of
application.
*Light - Barely perceptible
*Medium - Faintly grey
*Heavy - Opaque lesion

5. Development of adhesion over time
•Gains strength rapidly after second day to
reach maximum on 10-12 days
•Heavy burns-1175mg

6. Uses
•Prophylactic treatment of breaks.
•Localized area of detachment.
•Prophylactic treatment of areas of
abnormal vitreoretinal adhesion.
•Anterior retinal cryopexy.

7. Advantages & Disadvantages
•Can be applied through full thickness
sclera.
•Can be applied through hazy media.
•Can be safetly used over LPCN&Art.
•Has little effect on sclera.
•Break down of BRB.
•Greater intravitreal dispersion of RPE.
•CME is more