The use of liquid nitrogen cryospray for treatment of trichiasis

Cryosurgical destruction of eyelashes has been succesful using a double freeze-thaw liquid nitrogen spray technique. While other cryogens are successful in treating trichiasis, they are contraindicated in the treatment of malignant eyelid lesions. If the clinician intends to treat both these entities, it would be simpler to use a liquid nitrogen unit; otherwise, two separate cryosurgical instruments would be required. The liquid nitrogen treatment requires two cycles of a rapid freeze to -15°C coupled with a slow thaw and has given us a 90%+ success rate. Contraindications in treating trichiasis with cryotherapy include paralytic lids and heavily pigmented patients. In general, we do not treat trichiasis involving less than one-third of the lid, especially with young, healthy-appearing lid margins.