Cyrotherapy for Eyelash Follicle Destruction

This is Richard Allen at the University of lowa. This video demonstrates the use of cryotherapy for the destruction of eyelashes. The patient has a history of a medial lateral tar sophy for exposure keratopathy. The patient developed an area of DySIS postoperative. The area has been anesthetized with lidocaine with epinephrine. The cryo probe is placed in the area of the aberrant lashes and freezing is attained. The probe will reach a temperature of minus 80 degrees Fahrenheit and the destruction of lashes of the lower lid of freezing should be performed for approximately 25 seconds.

This is then allowed to thaw and the probe is placed along the area next to it for the upper eyelid. The lashes are a bit more resistant to cryotherapy and a freezing of approximately 35 seconds is performed in order to attain destruction of the lash follicles. A double free saw is performed after complete thawing. The cryo probe is again placed in the area medially. You will notice on the second freezing cycle that the ice ball appears more quickly. Again, this is performed for 25 seconds and then the area is allowed to completely thaw. The probe will then be moved adjacent with a slight overlap and additional freeze thaw is performed. You need to be aware that there is significant swelling and pain after cryotherapy to the eyelid. Also, hypopigmentation can occur and the procedure should probably not be performed in patients with significant pigment. Appellation of the lashes is then performed in this case with a needle holder. Ideally, the lashes slide out with minimal resistance. At the conclusion of the case, all lashes have been removed.