We aim to describe different imaging modalities to localize cyclodialysis clefts and direct cyclopexy repair of cyclodialysis clefts. We reviewed the record of a patient with traumatic cyclodialysis cleft who underwent direct cyclopexy retrospectively. Preoperative and postoperative visual acuity and intraocular pressure (IOP) were recorded. Gonioscopy, ultrasound biomicroscopy (UBM) and 360° swept-source anterior segment optical coherence tomography (SS-ASOCT) were used to localize the cyclodialysis cleft. We concluded that UBM is the current gold standard imaging modality in localization of cyclodialysis clefts, and that SS-ASOCT is potentially useful as alternative imaging modality. Direct cyclopexy is an effective treatment for large cyclodialysis cleft with good IOP control and visual outcomes.
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http://dx.doi.org/10.4103/tjo.tjo_24_21 | DOI Listing |
Cureus
January 2025
Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, JPN.
Persistent hypotony following Tanito microhook trabeculotomy (TMH) is rare but may occur due to the development of cyclodialysis clefts. We report a case of a Japanese man in his 40s who developed persistent hypotony and hypotony maculopathy after TMH in the left eye. Fourteen months after the surgery, the patient was referred to our institution due to prolonged hypotony that remained undiagnosed and untreated despite evaluations with gonioscopy and anterior segment optical coherence tomography (AS-OCT) at the referring clinic.
View Article and Find Full Text PDFEur J Ophthalmol
November 2024
Fundación de Oftalmología Médica de la Comunitat Valenciana, Valencia, Spain.
Purpose: To describe an alternative technique used in massive post-traumatic cyclodialysis. Classic techniques such as direct cyclopexy are performed ab externo and entail a higher risk of endophthalmitis or ciliary body hemorrhage. Therefore we present a case report using combined sewing machine technique cyclopexy with transscleral diode cyclophotocoagulation for complete post-traumatic cyclodialysis.
View Article and Find Full Text PDFInt Med Case Rep J
May 2024
Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan.
Introduction: Although ab-interno trabeculotomy-related (goniotomy-related) surgeries has a favorable safety profile, cyclodialysis cleft refractory to conservative management could occur, thereby requiring additional surgical treatment. External and, more recently, internal cycloplexy have been attempted to treat cyclodialysis clefts with hypotony maculopathy, however the traditional methods require conjunctival or scleral incisions and have been inappropriate for glaucoma patients who need to undergo future trabeculectomy. Therefore, we report two cases who underwent a novel reliable technique for suture fixation of the detached ciliary body onto the original scleral bed directly through the intraocular approach without conjunctival or scleral incision, minimally invasive direct internal cyclopexy, in the management of goniotomy-related cyclodialysis cleft with hypotony maculopathy.
View Article and Find Full Text PDFRetin Cases Brief Rep
January 2024
Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo.
Purpose: To report a surgical technique of cyclopexy, wherein two laps of encircling continuous sutures are placed around the limbus to treat refractory extensive cyclodialysis.
Methods: Color fundus photography, swept-source optical coherence tomography (OCT) for the anterior segment, and spectral-domain OCT for the macula.
Results: Previous attempts, including indirect cyclopexy and direct external cyclopexy with gas injection, failed to successfully resolve the severe cyclodialysis and associated hypotonic maculopathy.
Cornea
November 2022
Casey Eye Institute, Oregon Health and Science University, Portland, OR.
Purpose: The purpose of this study was to report a rare case of cyclodialysis cleft after secondary intraocular lens (IOL) placement using the Yamane flanged intrascleral haptic fixation technique.
Methods: This study is an observational case report.
Results: A 74-year-old man with an ocular history of spontaneously dislocated IOL and subsequent anterior chamber IOL (ACIOL) placement presented with monocular diplopia secondary to ACIOL subluxation.
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