To evaluate success rate of combined therapy for trichiasis since previous audit period.
To compare results achieved with the new Ellman® radiosurgery device to those achieved with the previous electrothermal method.

Retrospective review of case-notes (n=29) of Trichiasis between 2009 and 2014 who underwent electrolysis by Ellman radiosurgery followed by triple freeze-thaw cryotherapy.
All cases were undertaken at a day case ophthalmology unit by one oculoplastic surgeon under local anaesthetic.
Success rate was compared to previous audit where electrothermal device was used for electrolysis (2000-2004).

29 patients aged between 49-86 (mean = 72, 15M:F14) were included.
5/29 patients had bilateral disease therefore 34 procedures were performed. Blepharitis/Meibomian Gland Dysfunction (21/34 – 61.8%) was the most frequent aetiology/indication.
At 8 weeks, 33/34 (97.1%) of procedures had no recurrence of disease, however 3/34 (8.8%) had new eyelash formation adjacent to the treated area. This sub-group were epilated and are under follow-up but have not required retreatment since 2014.
1 patient with bilateral disease developed a unilateral recurrence, which fully resolved following re-retreatment. There were no reports of depigmentation, notching, excessive pain or severe inflammation.

Combined cryotherapy and electrolysis for trichiasis caries a higher success rate than either individual treatment. There were no significant side effects or serious complications of note and therefore combined therapy could represent a new gold standard when compared to previous treatment modalities.