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. The patient underwent explantation of the subluxed ACIOL and placement of a scleral-fixated IOL using the Yamane technique. The postoperative course was complicated by persistent hypotony, prompting ultrasound biomicroscopy, which revealed a cyclodialysis cleft adjacent to one of the externalized IOL haptics. The haptic was discovered in the involved supraciliary space while performing direct cyclopexy. The cyclodialysis cleft closed with return to physiologic intraocular pressure.
Conclusions: Cyclodialysis cleft formation is a possible complication of scleral IOL fixation and should be suspected in cases of prolonged postoperative hypotony. Extended longitudinal tracking of the needle and haptic through the supraciliary space may be one mechanism for cyclodialysis cleft formation in the Yamane technique.
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http://dx.doi.org/10.1097/ICO.0000000000003059 | 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 PDFOphthalmic Plast Reconstr Surg
December 2024
Section of Ophthalmology, Department of Surgery.
We describe an oculofacial injury phenotype manifesting as a cleavage plane following the orbitomalar ligament in 5 cases. Across these cases, curvilinear wounds followed the course of the orbitomalar ligament, running clean planes through orbicularis oculi down to the infraorbital rim and arcus marginalis. One case involved bilateral orbitomalar ligaments, and 1 case involved the inferior canaliculus.
View Article and Find Full Text PDFJ Glaucoma
October 2024
Department of Ophthalmology, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, Japan.
Retina
July 2024
Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
Background: The traditional suturing method for cyclodialysis cleft usually requires an incision in the sclera for direct suturing, resulting in greater damage and a high risk of postoperative complications. The purpose of this work is to propose a newly intrascleral double continuous suture repair technique for the treatment of cyclodialysis clefts.
Methods: Seven patients with cyclodialysis cleft underwent microinvasive intrascleral double continuous suture repair surgery to restore the attachment of the detached ciliary body to the sclera without scleral incision.
Int 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.
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