Radiofrequency Procedure-additional

Question 1

Additional radio frequency procedures

Answer 1

– Trichiasis
– Telangiectasia
– Hemangioma
– Molluscum Contagiosum
– Syringoma
– Punctoplasty
– Punctal Occlusion
– Punctal Occlusion
– Conjunctivochalasis
– Chalazion Incision
– Excisional Biopsy
– Xanthalasma

Question 2

Indication for RF for trichiasis

Answer 2

Bothersome Lashes with corneal discomfort/staining/and/or scarring

Question 3

Procedure for trichiasis for RF

Answer 3

• Anesthetize lower lid at margin with topical or local anesthetic
• Grab lash with forceps
• Place needle beside lash shaft into the follicle (until it cannot go further)
• Tap the foot pedal and immediately let off
• Gently pull lash → smoothly comes out = finished → If not repeat again

Question 4

Specs for trichiasis RF

Answer 4

• Micro-insulated needle tip

* Mode 3 @ ~1-2

Question 5

Indication for RF for telegectasia

Answer 5

Cosmetically bothersome or irritating

Question 6

Procedure for RF for telangiectasia

Answer 6

• Anesthetize skin with topical transdermal anesthetic cream
• With very light pressure, gently touch center of telangiectasia
• Tap the foot pedal and immediately let off

Question 7

Specs for telangiectasia

Answer 7

• Micro-insulated needle tip

* Mode 3 @ ~1-3

Question 8

Indication for RF for hemangioma

Answer 8

Elevated, blood filled anastomais of vessles

Question 9

Procedure for RF for hemangioma

Answer 9

• Anesthetize lesion and surrounding tissue with local anesthetic
• With very light pressure, gently touch center of the hemangioma
• Tap the foot pedal and immediately let off
– The lesion should turn dark when done correctly

Question 10

Specs for RF for hemangioma

Answer 10

• Broad base needle, ball, or pin tip

* Mode 3 @ ~1-3

Question 11

Indication for RF for molluscum contagiosum

Answer 11

Single or multiple pearly white umbilicated central keratin plug lesions

Question 12

Procedure for RF with molluscum

Answer 12

• Anesthetize lesion with topical or local anesthetic
• Place electrode within center of lesion
• Tap the foot pedal and immediately let off

Question 13

Specs for RF for molluscum

Answer 13

• Ball tip

* Mode 3 @ ~1-3

Question 14

Indication for RF for syringoma

Answer 14

Benign eccrine sweat duct neoplasms

Common on lower eyelid, more common in females after puberty

Question 15

Procedure for RF

Answer 15

• Anesthetize lesion with local anesthetic
• Place electrode within center of lesion
• Tap the foot pedal and immediately let off

Question 16

Specs for RF for molluscum

Answer 16

• Pin tip

* Mode 3 @ ~1-3

Question 17

Indication for punctiplasty RF

Answer 17

Punctual stenosis with symptomatic epiphora

Question 18

Procedure for RF for punctoplasty

Answer 18

• Anesthetize lower punctal area with local anesthetic
• Place electrode at edge of punctum and made a small sweeping motion to enlarge the opening
– Careful to not go too deep to puncture through the canaliculi**

Question 19

Specs for RF for punctoplasty

Answer 19

• Micro-insulated needle tip

* Mode 3 @ ~1-3

Question 20

Indication for punctal ectropion RF

Answer 20

• Poor punctal apposition with symptomatic epiphora

* Open punctum

Question 21

Procedure for punctal ectropion RF

Answer 21

• Anesthetize lower punctal area with local anesthetic
• Place bipolar forceps parallel with the punctum at the bottom of tarsus
directly below punctum
• Tap the foot pedal and immediately let off

Question 22

Specs for RF for punctal ectropion

Answer 22

• Bipolar forceps

* Mode 3 @ ~1-3

Question 23

Punctal occlusion RF indication

Answer 23

• Dry eye syndrome/ocular surface disease

* Where medical management and reversible punctal occlusive therapy have failed

Question 24

Procedure for RF for punctal occlsion

Answer 24

• Anesthetize lower punctal area with topical or local anesthetic
• Place electrode within punctum • Tap the foot pedal and immediately let off
– This creates mucosal scarring and closure

Question 25

Specs for punctal occlusion RF

Answer 25

* Broad base needle tip | * Mode 3 @ ~1-3

Question 26

Indication for R for conjunctivochalasis

Answer 26

• Redundant conjunctiva with symptomatic foreign body sensation

Question 27

Procedure for RF for conjunctivochalasis

Answer 27

* Anesthetize conjunctiva with several drops of tetracaine * Retract lower lid * Place redundant conjunctiva within forceps parallel to lid margin * Activate electrode and gently tap conjunctiva between forceps until it becomes cloudy

Question 28

Specs for RF for conjunctivochalasis

Answer 28

* Broad base needle tip | * Mode 3 @ ~1-3

Question 29

Indication for RF for chalazion incision

Answer 29

Chalazion

Question 30

Procedure for RF for chalazion incision

Answer 30

* Anesthetize chalazion with local anesthetic | * Clamp chalazion and incise with wire tip (as if you would if it were a scalpel)

Question 31

Specs for RF for chalazion incision

Answer 31

* Thin wire tip | * Mode 1 or 2 @ ~3-5

Question 32

Indication for RF for excisional biopsy

Answer 32

Need to remove lesion with complete borders

Question 33

Procedure for excisional biopsy with RF

Answer 33

* Anesthetize lesion and surrounding tissue with local anesthetic * Cut an elliptical incision/excision surrounding lesion * Place a suture/Dermabond/butterfly after removal

Question 34

Specs for RF for excisional biopsy

Answer 34

* Pin or thin wire tip | * Mode 1 @ ~3-5

Question 35

Indication for RF for xanthelasma

Answer 35

• Raised, soft, yellow skin plaques made of cholesterol deposit – If noted in children

Question 36

Procedure for xanthelasma RF

Answer 36

* Anesthetize lesion and surrounding tissue with local anesthetic * Gently sweep over lesion in a tapping motion, starting at borders until the patch is flat

Question 37

Specs for xanthelasma RF

Answer 37

* Pin, ball, or broad tip | * Mode 3 @ ~1-3