Morteza Entezari, Alireza Ramezani, Hamid Ahmadieh, Pejman Bakhtiari, Mehdi Yaseri (Ophthalmic Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran)


To present the disadvantages of cryotherapy of sclerotomy sites in prevention of late (after 4 weeks) post-vitrectomy diabetic hemorrhage. There is a hypothesis that cryotherapy of sclerotomy sites by preventing fibrovascular ingrowth may decrease the rate of post-vitrectomy diabetic hemorrhage. Based on a clinical tr ial, however, we reached to an opposite conclusion.


After closure of the sclerotomy sites at the end of the vitreous surgery, we applied two cryotherapy spots at each sclerotomy site. The duration for each spot was up to 3 seconds after formation of the ice ball.

Effectiveness / Safety:

In a clinical trial comparing this procedure with no treatment, we found not only the ineffectiveness of this method but also its risky effect. The rate of vitreous hemorrhage up to 6 months was significantly higher in the eyes receiving cryotherapy (29.4%) compared to the controls (9.1%) (P=0.035). Fibrovascular ingrowth, detected by ultrasound biomicroscopy, was noticed in 46% and 30% of the cases and controls, respectively (P=0.4). Take home message: Cryotherapy of sclerotomy sites is not helpful for prevention of late post-vitrectomy diabetic hemorrhage and it may even increase the risk.