What is Retinal Cryotherapy

Retinal cryotherapy is a procedure that treats diseases of the retina using extreme cold temperature (cryotherapy). The retina is a thin membrane that covers the back of the inside of the eye. The retina is the part of the eye that sends signals to the brain along the optic nerve, which lets you see.

This procedure may be used to treat retinal tears or conditions that cause retinal bleeding, such as diabetic retinopathy.

During this procedure, a freezing metal probe is applied to the outside of the eye near the area of retinal abnormality inside the eye. The freezing causes scarring that seals any retinal bleeding or tears.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding under the outer lining of the eye (conjunctival bleeding).
• Allergic reactions to medicines.
• Damage to other eye structures.
• Inflammation of the wall of the eye, causing redness, pain, and blurred vision.
• Over-freezing or under-freezing, which may cause too much inflammation or allow the retinal abnormality to get worse.

What happens before the procedure?

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• You may have an eye exam, blood tests, and imaging tests.
• Do not use any products that contain nicotine or tobacco for as long as possible before the procedure. These include cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To lower your risk of infection, your health care team will wash or sanitize their hands.
• An IV tube may be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb your eye (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Eye drops may be placed in your eye to enlarge (dilate) your pupil. This allows your health care provider to see inside your eye.
• An instrument that holds your eye open (lid speculum) will be placed on your eye.
• Your surgeon will inspect your retina by looking through your eye with an eye scope. Your eye may be moved or squeezed to check for areas of retinal abnormality.
• The freezing probe will be placed against the outside of your eye near the affected areas. The probe will be applied to cause controlled scarring and sealing of blood vessels.
• Antibiotic drops or ointment may be placed in your eye.
• A protective covering (eye shield) may be placed over your eye.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You may be given pain medicine as needed.
• You may continue to have an eye shield covering your eye. Remove it only as directed.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Do not drive for 24 hours if you were given a sedative.

Summary

• Retinal cryotherapy is a procedure that treats diseases of the retina using extreme cold temperature (cryotherapy).
• This procedure may be used to treat retinal tears or conditions that cause retinal bleeding, such as diabetic retinopathy.
• Do not use any products that contain nicotine or tobacco for as long as possible before the procedure. These include cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic. If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• Wear your eye shield as told by your health care provider. Remove it only as directed.

Retinal Cryotherapy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• A protective covering (eye shield) over your eye.
• A scratchy sensation in your eye.
• Eye discomfort or pain.

After your eye shield is removed, it is common to have:

• Blurry vision.
• Redness in your eye.
• Swelling around your eye.

Follow these instructions at home:

Medicines

• Use eye drops and ointments as told by your health care provider. Do not stop using these eye medicines even if you start to feel better.
• Take over-the-counter and prescription medicines only as told by your health care provider.

Driving

• Do not drive or use heavy machinery until your health care provider approves.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.

Activity

• Do not exercise or do physical activity that requires a lot of effort (is strenuous) until your health care provider approves. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.

General instructions

• Wear your eye shield as told by your health care provider. Remove it only as directed.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Wear sunglasses during the day.
• Do not wear eye makeup or contact lenses until your health care provider approves.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain in your eye.
• You have a fever or chills.
• You have fluid or pus coming from your eye.
• Your vision gets worse.

Get help right away if:

• You have severe eye pain.
• You have sudden loss of vision.

Summary

• After the procedure, it is common to have eye discomfort, swelling, redness, and blurry vision.
• Use eye drops and ointments as told by your health care provider. Do not stop using these eye medicines even if you start to feel better.
• Do not exercise or do physical activity that requires a lot of effort (is strenuous) until your health care provider approves. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.
• Wear your eye shield as told by your health care provider. Remove it only as directed.