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cryotherapy in ophthalmology

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  2. 2. INTRODUCTION • Different methods to create chorioretinal adhesion. • Adhesion produced by all treatment is between the retina and pigment epithelium, but referred to as chorioretinal adhesion.
  3. 3. CRYOTHERAPY • Scholer; Freezing creates inflammation in the area of application. • Linde instrument employed CO2 or N2O as cryogenic agents. • Works on Joule-Thompson principal.
  4. 4. Effects on the tissue • Cryo causes dissolution of cellular membrane.Intracellular ice causes mechanical damage with rupture of cellular membrane. • Strength of adhesion between retina and RPE is proprotional to the intensity of application. *Light - Barely perceptible *Medium - Faintly grey *Heavy - Opaque lesion
  5. 5. Development of adhesion over time • Gains strength rapidly after second day to reach maximum on 10-12 days • Heavy burns-1175mg
  6. 6. Uses • Prophylactic treatment of breaks. • Localized area of detachment. • Prophylactic treatment of areas of abnormal vitreoretinal adhesion. • Anterior retinal cryopexy.
  7. 7. Advantages & Disadvantages • Can be applied through full thickness sclera. • Can be applied through hazy media. • Can be safetly used over LPCN&Art. • Has little effect on sclera. • Break down of BRB. • Greater intravitreal dispersion of RPE. • CME is more