Dr.gautam lokdarshi, L15233
A 17-year-old girl presented with recurrent squamous papilloma of posterior lid margin and whole tarsoconjunctiva of the left eyelid. Upper lid lamellar division was performed and relaxing vertical cut was placed on each tarsal end extending up to upper border of the tarsus. Cryo-probe (liquid nitrogen) was applied over the involved posterior lamella with double freeze-thaw technique. No recurrence, epiphora, dry eye or lid margin malposition was noted during one year follow up.
Multiple cycles of ‘rapid freeze- slow thaw’ cryotherapy at the base of papilloma are essential to prevent its recurrence, especially in younger patients. We believe that the two relaxing vertical cuts, after lamellar division, at the medial and lateral edges of tarsus safeguard the lid against cicatricial entropion or punctual malposition due to post-cryo-therapy scarring. This also places punctum or canaliculus away from the site of cryo-probe application and thus prevents direct damage to them.
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