Fraunfelder F T, Wallace T R, Farris H E, Watkins J, Hendrickson R, Smead W J, Limmer B L
Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977 Jul-Aug;83(4 Pt 1):713-24.
This preliminary report suggests that cryosurgery has a definite place in the management of certain external periocular and ocular problems. Cryosurgery for basal or squamous cell carcinoma of the lid is easily performed, gives excellent cosmetic results, and has a low recurrence rate. It is not recommended for lesions involving the fornices, or sclerotic and morphea-type basal cell carcinomas. Tumor recurrences following radiation, surgery, or cryosurgery can still be retreated with cryosurgery. To date, there is no evidence that cryosurgery at temperatures above -40 C causes damage to the lacrimal outflow system. Cryosurgery is of value in the management of trichiasis, reactive lymphoid hyperplasia, spider hemangioma, molluscum contagiosum, and conjunctival dysplasia. Cryotherapy for management of intraepithelial epithelioma and squamous cell carcinoma of the conjunctiva and cornea is still under investigation. Cryosurgery will, in our opinion, become the treatment of choice for basal and squamous cell carcinomas of the eyelids. The 96% cure rate with one treatment for these lesions reported here is artificially high since the follow-up period is too short. However, retreatment with cryosurgery is a simple ten-minute outpatient procedure which is certainly not the case with recurrences after other forms of therapy.
这份初步报告表明，冷冻手术在某些眼周和眼部外部问题的治疗中具有明确的地位。眼睑基底细胞癌或鳞状细胞癌的冷冻手术操作简便，美容效果极佳，复发率低。对于累及穹窿部的病变，以及硬化型和硬斑病样基底细胞癌，不建议使用冷冻手术。放疗、手术或冷冻手术后肿瘤复发，仍可采用冷冻手术进行治疗。迄今为止，尚无证据表明温度高于-40℃的冷冻手术会对泪液引流系统造成损害。冷冻手术在治疗倒睫、反应性淋巴样增生、蜘蛛状血管瘤、传染性软疣和结膜发育异常方面具有价值。结膜和角膜上皮内上皮瘤及鳞状细胞癌的冷冻治疗仍在研究中。我们认为，冷冻手术将成为眼睑基底细胞癌和鳞状细胞癌的首选治疗方法。此处报道的这些病变单次治疗96%的治愈率因随访期过短而人为偏高。然而，冷冻手术再次治疗是一个简单的十分钟门诊手术，而其他治疗方式复发后的情况肯定并非如此。
