Ophthalmology Questions Cryotherapy

What is the difference between cryotherapy and laser treatment for retinal tears?

I was just diagnosed with a small retinal tear and am trying to understand which option (cryotherapy or laser therapy) is the best. What is the difference between cryotherapy and laser treatment ?

12 Answers

Cryotherapy uses a freezing technique applied to the tear to initiate a seal of a retinal break. Laser uses high intensity light to initiate a sealing burn around a retinal break. Laser offers less inflammation but requires a clear view not obscured by cataract or hemorrhage.
Cryo is done from the outside of the eye. It freezes the deep tissue to cause scar and t his closes the small retinal tear. It has its limits as to how far back in the eye it can freeze. Laser is a welding shot (multiple) to surround the tear. It has its limits on  how froward in the eye it can be done. The laser is administered through the pupil and wit special lenses, both are very effective and the final choice should be made by the retinal surgeon. 
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Cryo uses cold to scar the retina onto the underlying choroid. Laser uses intense light to create a heat bond to do the same thing.
The retinal tear is repaired by using an instrument that "tacks" it down. Both laser and cryotherapy perform this task. Please discuss the options with your retinal specialist as there may be specific reasons for your particular recommendation.
Both treatments are almost always effective. Cryo (freezing) is used when the tear is too far peripheral to be treated fully by the laser, or if a fairly dense cataract is present blocking a clear view for laser treatment. Cryo is usually more uncomfortable during treatment, but it only lasts a few seconds. Most of the time laser treatment is painless.

Mark F. Pyfer, MD, MS, FACS
Great question. Laser is delivered internally and passes through the cornea lens and into the area around the retinal tear. It creates a thermal scar and seals around the tear.

Cryopexy is a freezing treatment and it is delivered externally from the outside in. Both form a seal around the tear. Cryopexy can sometimes be our only option if the view in is compromised by haze say from blood. The blood can limit the ability of the laser light beam to pass internally to the area around the tear.

Cryopexy can leave the eye red and often needs additional numbing but both prevent progression of the tear to a retinal detachment. Both can be performed as an outpatient within an office.
Both are effective. The laser is easier on the patient and better for comfort and smaller treatments. For larger, more destructive treatment, they use cryo. The crying is very effective, but causes more post-operative inflammation and swelling.

Both can be used effectively for retinal tears. Laser is more readily available in most clinics, cryo may require a trip to a surgery center. I would discuss this with a retina specialist as that is their specialty.
They both work well. The doctor usually will tell you which is best in your case.
The treatment for retinal holes is to cause 360 degree scarring around the hole to prevent it from becoming a detachment. One way to do that is lasering a 360 degree ring around the hole sealing it off. Another is by freezing the eye at the site of the hole, killing that area, therefore causing a scar at the site of the hole. They both work, but laser is easier and painless and does not require more than an anesthetic eye drop. Cryo is extremely painful without some kind of a major local anesthesia (like a shot). For the patient, laser is easier to sit through. However, I usually tell patients, whatever the retina specialist is more comfortable doing, that’s what you stick with. I would just discuss the options with your retina specialist.

Best of luck.

Essentially the same purpose- to create a scar around the tear to seal it, preventing a retinal detachment from ongoing vitreous traction on the tear. The laser is applied when the tears are more toward the back and the vitreous is clear so that the laser can be aimed back to the retina. Cryo is applied when the tears are in the retina more toward the from of the eye or if there is blood in the vitreous gel. Both have the same rate of success (failure about 5-7%). Either procedure needs to be done immediately to protect the eye against progressing to a retinal detachment
Cryotherapy uses a very cold tip of -80 C to freeze the area of the retina adjacent to the retina tear thereby causing a freeze burn that will encourage the retina to react and form a scar to seal the retina. Laser therapy uses a light beam to create tiny laser burns on the retina to cause scaring and then seal the tear. Laser is more precise and less painful.