Cryosurgery for Eyelid Basal Cell Carcinomas: A Practical Guide
Basal cell carcinomas (BCCs) of the eyelids may be difficult to treat without damaging structures vital for the eyelid function. Excisional surgery is still the most widely used modality worldwide. Cryosurgery, however, has proven to be a simple treatment modality with little impact on the tissues and a low recurrence rate. Although the technique is easy to manage, thorough training and proper patient selection are essential to achieve a good result. As regards patient selection, only patients with well-delineated nodular BCCs should be treated. Hence, a preoperative biopsy should be carried out in order to determine the subtype of BCC. Regarding the treatment technique, local infiltration anaesthesia is used in the eyelids and anaesthetic drops in the eye. A plastic shield is usually used to protect the eye from the cold. Liquid nitrogen is sprayed into a neoprene cone to concentrate the spray. Usually, a freeze time of 20–30 s is used. The halo thaw time should exceed 60 s. The entire lesion is then allowed to thaw and the cycle repeated once more. Results are generally excellent, but in 10 % of cases, a conjunctival overgrowth occurs.
KeywordsRubber Adrenalin Ooze Neoprene
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