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Nitrous oxide cryotherapy for primary periocular basal cell carcinoma: outcome at 5 years follow-up
  1. I Moesen1,2,
  2. M Duncan2,3,
  3. C Cates2,4,
  4. A Taylor2,5,
  5. R V Wintle2,6,
  6. A Ismail2,7,
  7. D Khan Lim2,8,
  8. A G Tyers9
  1. 1Moorfields Eye Hospital, London, UK
  2. 2Salisbury District Hospital, Salisbury, UK
  3. 3Canberra Eye Hospital, Canberra, Australia
  4. 4West Suffolk Hospital, Bury St Edmonds, UK
  5. 5Princess Margaret Hospital for Children, Perth, Australia
  6. 6West Wales General Hospital, Carmarthen, UK
  7. 7St Albans City Hospital, St Albans, UK
  8. 8Southampton University Hospital, Southampton, UK
  9. 9Salisbury District Hospital, Salisbury, UK
  1. Correspondence to Anthony G Tyers, Department of Ophthalmology, Salisbury District Hospital, Odstock Road, Salisbury SP2 8BJ, UK; anthony.tyers{at}


Aim To report the outcome at 5-year follow-up of a defined series of patients with primary periocular basal cell carcinoma treated by cryotherapy using a nitrous oxide probe.

Methods A prospective, non-comparative, interventional case series. One hundred primary periocular basal cell carcinomas were treated with a double freeze–thaw cycle nitrous oxide contact cryotherapy probe. Inclusion criteria were clinically well-defined primary periocular basal cell carcinomas with maximum diameter of 8 mm. The main outcome measure was histologically proven recurrence rate at 5-year follow-up.

Results Kaplan–Meier survival analysis showed a 5-year recurrence rate of 8%. Cox regression analysis revealed no correlation between tumour site, tumour size, cryotherapy freeze time and recurrence (p=0.60, p=0.86 and p=0.71, respectively). Thirty-six per cent of patients were lost to follow-up at 5 years following treatment.

Conclusion The results of this series suggest that nitrous oxide probe cryotherapy for primary periocular basal cell carcinomas up to 8 mm diameter has a recurrence rate of ∼8%. Cryotherapy has certain advantages over surgical removal of tumours of this size in the periocular region, but careful follow-up is advisable.

  • Basal cell carcinoma
  • cryotherapy
  • eyelids
  • nitrous oxide

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  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Salisbury District Hospital Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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