Cryosurgery pp 237-243 | Cite as

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.


Basal Cell Carcinoma High Cure Rate Good Cosmetic Result Freeze Time Thaw Time 
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  1. 1.
    Loeffler M, Hornblass A. Characteristics and behavior of eyelid carcinoma (basal cell, squamous cell sebaceous gland, and malignant melanoma). Ophthalmic Surg. 1990;21(7):513–8.PubMedGoogle Scholar
  2. 2.
    Saari KM, Paavilainen V, Tuominen J, Collan Y. Epidemiology of basal cell carcinoma of the eyelid in south-western Finland. Graefe’s archive for clinical and experimental ophthalmology. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 2001;239(3):230–3.CrossRefGoogle Scholar
  3. 3.
    Biro L, Price E. Basal-cell carcinomas of eyelids: experience with cryosurgery. J Dermatol Surg Oncol. 1979;5(5):397–401.PubMedCrossRefGoogle Scholar
  4. 4.
    Buschmann W, Linnert D. Stickstoff-Kryotherapie von Lidbasaliomen. [Nitrogen cryotherapy of lid basaliomas (author’s transl)]. Klin Monbl Augenheilkd. 1980;177(3):345–53.PubMedCrossRefGoogle Scholar
  5. 5.
    Fraunfelder FT, Farris Jr HE, Wallace TR. Cryosurgery for ocular and periocular lesions. J Dermatol Surg Oncol. 1977;3(4):422–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Kuflik EG. Cryosurgery for basal-cell carcinomas on and around eyelids. J Dermatol Surg Oncol. 1978;4(12):911–3.PubMedCrossRefGoogle Scholar
  7. 7.
    Zacarian SA. Cancer of the eyelid–a cryosurgical approach. Ann Ophthalmol. 1972;4(6):473–80.PubMedGoogle Scholar
  8. 8.
    Kokoszka A, Scheinfeld N. Evidence-based review of the use of cryosurgery in treatment of basal cell carcinoma. Dermatol Surg. 2003;29(6):566–71.PubMedCrossRefGoogle Scholar
  9. 9.
    Lindgren G, Larko O. Long-term follow-up of cryosurgery of basal cell carcinoma of the eyelid. J Am Acad Dermatol. 1997;36(5 Pt 1):742–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Kersten RC, Bartley GB, Nerad JA, Neuhaus RW, Nowinski TS, Popham JK, Beardsley TL. Orbit, eyelid, and lacrimal system. Series: basic and clinical science course, section 7. San Francisco: American Academy of Ophthalmology; 2002.Google Scholar
  11. 11.
    Jaramillo-Ayerbe F. Cryosurgery in difficult to treat basal cell carcinoma. Int J Dermatol. 2000;39(3):223–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Mohs FE. Micrographic surgery for the microscopically controlled excision of eyelid cancers. Arch Ophthalmol. 1986;104(6):901–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Pieh S, Kuchar A, Novak P, Kunstfeld R, Nagel G, Steinkogler FJ. Long-term results after surgical basal cell carcinoma excision in the eyelid region. Br J Ophthalmol. 1999;83(1):85–8.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Anderson R. A warning on cryosurgery for eyelid malignancies. Arch Ophthalmol. 1978;96(7):1289–90.PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of OphthalmologySahlgrenska University HospitalMölndalSweden
  2. 2.Department of DermatologyThe Sahlgrenska Academy, Sahlgrenska University Hospital, University of GothenburgGothenburgSweden

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