Patient Education
Cryotherapy (Cryopexy)
In-office · about 15–30 minutes
Cryotherapy, also called cryopexy, uses a cold-tipped probe applied to the outside of the eye to freeze through the eye wall and create a scar that seals the retina down. It does the same job as laser retinopexy, but reaches places the laser cannot: tears far in the periphery, tears obscured by blood or a dense cataract that blocks the laser beam, and certain peripheral lesions that need to be treated from the outside in..
Cryotherapy, also called cryopexy, uses a cold-tipped probe applied to the outside of the eye to freeze through the eye wall and create a scar that seals the retina down. It does the same job as laser retinopexy, but reaches places the laser cannot: tears far in the periphery, tears obscured by blood or a dense cataract that blocks the laser beam, and certain peripheral lesions that need to be treated from the outside in.
What It Treats
- Retinal tears
- Peripheral retinal holes and dialyses
- Retinal detachment repair, as part of surgery
- Peripheral lesions, including Coats disease and peripheral vascular lesions
What to Expect
Before
Your eye is dilated. Because freezing is felt more than laser, anesthesia is usually given as an injection beneath the surface tissue or behind the eye rather than drops alone. Your eyelids and the surface of the eye are cleaned.
During
The doctor wears an indirect ophthalmoscope and presses the cold probe against the outside of the eye, over the area of the tear, watching from inside as the freeze whitens the retina and releasing it as soon as the treatment is adequate. You will feel firm pressure and a deep ache. Each freeze lasts a few seconds, and several are placed around the lesion.
After
The eye will be red and the lids swollen, and it will ache. Cryotherapy produces noticeably more inflammation and soreness than laser, and the eye looks worse than it is. The seal strengthens over about two weeks, the same as with laser.
Recovery & Restrictions
- A driver is required — the anesthetic alone makes driving unsafe.
- Expect aching and soreness for one to three days. Acetaminophen is usually sufficient; cool compresses help the lid swelling.
- Redness and puffiness peak in the first couple of days and settle over about a week.
- Anti-inflammatory or dilating drops are often prescribed; use them as directed.
- Avoid heavy lifting and strenuous activity while the seal matures over the first one to two weeks.
- As with laser, a new curtain, shadow, or burst of flashes afterward means you need to be seen the same day.
Risks & Side Effects
More inflammation than laser
Swelling, redness, and discomfort are expected and greater than after laser. Severe or worsening pain is not expected and should be reported.
Temporary double vision or a drooping lid
Caused by the anesthetic reaching the muscles around the eye. It resolves as the block wears off, usually within hours.
Bruising and lid swelling
Common and cosmetic. It can look alarming for several days.
Scar tissue formation
Heavy cryotherapy releases pigment cells into the eye and is associated with membrane formation on the retina, which can occasionally need surgery later. This is part of why laser is preferred when it can reach the lesion.
Macular swelling
Uncommon, but swelling in the center of the retina can follow treatment and may need its own treatment.
Every procedure carries risk, and this list is not exhaustive. Your doctor will discuss the risks that apply to your eye and your circumstances before you decide.