Current concepts in the management of cyclodialysis

Senthilkumar, Vijayalakshmi A; Rajendrababu, Sharmila

doi:10.4103/tjosr.tjosr_77_20

Cited by 2 publications

(5 citation statements)

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“…Laser-based treatments, such as ab interno argon laser photocoagulation and ab externo transscleral YAG or diode laser cyclophotocoagulation, act by generating a localized inflammatory reaction that stimulates cleft closure. However, the outcomes of these approaches can be unpredictable, and they are usually reserved for small clefts [ 1 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical modalities, namely direct cyclopexy, scleral buckling, vitrectomy (either alone or in combination with cryotherapy or endotamponade), and implantation of a CTR or IOL in the ciliary sulcus, are required for larger clefts, but they have all the inherent risks of invasive intraocular procedures [ 1 , 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Intracameral injection of a viscoelastic agent may be necessary to increase its effectiveness, since media opacity and globe hypotony can hamper the accurate identification of a cleft. Other noninvasive diagnostic techniques such as ultrasound biomicroscopy (UBM) are now an extremely valuable tool, as they not only increase the odds of cleft identification but also localize and measure the extent of the lesion, thus helping to delineate the best management plan [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Conservative medical treatment is usually used as a first-line option, but its success is limited to cases with small clefts. Therefore, more invasive techniques (ranging from laser-based to surgical interventions) are almost always necessary to restore normal ocular tonus [ 1 , 2 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Traumatic Cyclodialysis Cleft Treatment Combined with Cataract Surgery: An Original Triple Procedure

et al. 2021

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Introduction: To describe a ''triple'' surgical procedure, which combined traumatic cataract extraction by phacoemulsification with gas endotamponade and cyclocryotherapy in the successful treatment of a traumatic cyclodialysis cleft. Methods: A 44-year-old man who suffered severe left eye blunt trauma with an elastic band developed a 4-hour extent cyclodialysis cleft with consequent hypotony. After 7 weeks of persistent hypotonic maculopathy unresponsive to medical treatment, and with an evolving traumatic cataract, the patient underwent cataract surgery combined with intravitreal gas endotamponade (20% SF6) and cyclocryotherapy.Results: Two weeks after the procedure the intraocular pressure increased to 12 mmHg and remained steady during the next 14 months of follow-up. Hypotonic maculopathy resolved and successful closure of the cyclodialysis cleft was confirmed by gonioscopy and ultrasound biomicroscopy. Conclusion:Gas endotamponade and cyclocryotherapy constitute a promising option in the treatment of cyclodialysis clefts unresponsive to medical therapy. In our case, this minimally invasive technique was innovatively combined with cataract surgery. Despite early postoperative intraocular inflammation, a successful outcome was achieved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Traumatic Cyclodialysis Cleft Treatment Combined with Cataract Surgery: An Original Triple Procedure

et al. 2021

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“…1 A precise diagnosis of a CDC is usually challenging due to the low tonicity of the eye and the ocular comorbidities associated with ocular trauma or injury. 2 Clinical signs may include hypotony, choroidal detachment, and an abnormal iris configuration. Gonioscopy is crucial in visualizing the cleft's location and extent, while ultrasound biomicroscopy (UBM) provides highly detailed anatomical information, aiding in precise localization and determination of cleft dimensions.…”

mentioning

confidence: 99%

Challenging diagnosis and repair of an extensive cyclodialysis cleft

Braudo,

Neuman,

Shitrit

et al. 2024

JCRS Online Case Rep

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Introduction: This report describes a challenging case involving the diagnosis and surgical repair of an extensive cyclodialysis cleft (CDC) in a young, phakic patient. Patient and Clinical Findings: A 25-year-old man presented with ocular pain, visual impairment, eyelid hematoma, subconjunctival hemorrhage, and Berlin edema after blunt trauma to the right eye. Initial conservative treatment with medications was converted to surgery due to hypotony-induced maculopathy. Diagnosis, Intervention, and Outcomes: Ultrasound biomicroscopy (UBM) and gonioscopy revealed extensive supraciliary and suprachoroidal fluid and a CDC whose dimensions were inconclusive. However, consequent intraoperative UBM provided precise real-time anatomical evidence of an extensive CDC extending 8 clock hours and mandating closure with a direct cycloplexy approach. Layered scleral dissection and direct suturing of the ciliary body to the sclera were performed with 8-0 nylon sutures, resulting in CDC resolution, supraciliary and suprachoroidal fluid absorption, visual acuity improvement, and intraocular pressure stabilization. Conclusions: This case highlights the innovative use of intraoperative UBM as a critical tool, offering real-time guidance in managing an extensive CDC. The successful closure and improved visual outcomes in this case further validate the efficacy of direct cycloplexy for extensive CDCs.

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Current concepts in the management of cyclodialysis

Cited by 2 publications

References 1 publication

Traumatic Cyclodialysis Cleft Treatment Combined with Cataract Surgery: An Original Triple Procedure

Traumatic Cyclodialysis Cleft Treatment Combined with Cataract Surgery: An Original Triple Procedure

Challenging diagnosis and repair of an extensive cyclodialysis cleft

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