Customized Cryotherapy for Ocular Salvage in Descemetocele and Iris Prolapse: A 17-Year Retrospective Study

AIM: To evaluate the efficacy of a customized cryotherapy technique in enhancing ocular salvage and reducing evisceration rates in patients with descemetocele and iris prolapse. MATERIAL AND METHODS: A retrospective, observational study was conducted at SMEC Eye Hospital, Medan, including 467 eyes from 467 patients treated with customized cryotherapy between January 2008 and July 2025. The procedure integrated standardized cryotherapy with adjunctive perioperative protocols, including antiseptic preparation, postoperative antibiotic, anti-inflammatory, and beta-blocker eyedrops, as well as strict environmental precautions and protective eyewear. Outcomes assessed were the need for repeated cryotherapy and evisceration. RESULTS: Of the 467 treated eyes, 454 (97.2%) were successfully preserved without requiring evisceration. Repeated cryotherapy was required in 11 eyes (2.2%), of which 10 achieved ocular preservation. Evisceration was ultimately required in 13 eyes (2.8%), primarily due to spontaneous ocular content prolapse. Most treated eyes demonstrated corneal wall thickening and scarring, with regression of iris prolapse, thereby restoring ocular contour. CONCLUSION: Customized cryotherapy is a highly effective intervention for preventing evisceration in eyes with descemetocele and iris prolapse. By stabilizing the corneal wall and mitigating the risk of spontaneous ocular prolapse, this technique represents a valuable strategy for ocular salvage. Further prospective and controlled studies are warranted to validate long-term outcomes and to optimize treatment protocols.