Complications of cryosurgery

J. R. Wood and R. L. Anderson

We describe 70 patients who underwent cryosurgery to the lids during a two-year period. Of the 58 receiving adequate follow-up, approximately one fourth had complications thought to be directly caused by cryosurgery. These include visual loss, lid notching, corneal ulcer, acceleration of symblepharon formation, xerosis, cellulitis, activation of herpes zoster, skin depigmentation, and severe soft-tissue reaction. In addition, 9% of the lids showed possible induction of trichiasis in areas adjacent to treatment. More than two thirds of patients with conjunctival shrinkage or grafted or irradiated lids had adverse effects, with one case of permanent visual loss. Misdirected lashes were successfully eliminated with a single double freeze-thaw technique in 90% of lids treated. Cryosurgery for aberrant lashes and some benign lid lesions is the most effective method of therapy presently available, but one must be aware of its potential complications. It has a low complication rate in "normal" lids, but should be used with caution in patients with conjunctival shrinkage or in those with grafted and/or irradiated lids.