Cyclodialysis cleft secondary to removal of an anterior chamber phakic intraocular lens

Abstract

We present a patient who had decreased visual acuity and hypotony in the left eye 2 months after removal of an anterior chamber phakic intraocular lens (pIOL). Gonioscopy demonstrated a cyclodialysis cleft at the 6 o'clock position in the region of the IOL footplate, which was confirmed by ultrasound biomicroscopy. A cyclodialysis cleft formation is one possible complication of pIOL removal. Careful gonioscopy evaluation before removal of pIOLs should be mandatory to assess the amount of fibrosis and the presence of synechia between the IOL and the surrounding tissues.

Anterior chamber phakic intraocular lens implantation in children to treat severe anisometropic myopia and amblyopia: 3-year clinical results

“…12 Other complications after Artisan or Artiflex pIOL implantation in adult populations include traumatic aniridia, cataract development, iritis, pigment dispersion, Urrets-Zavalia syndrome, cyclodialysis cleft formation, traumatic dislocation, endophthalmitis, and toxic anterior segment syndrome. [24][25][26][27][28][29][30][31][32][33] Regarding RLE versus iris-supported AC pIOL implantation, the former is an irreversible procedure with potentially greater long-term risks and complications, including a higher rate of retinal detachment and significant visual loss, particularly in younger patients. [34][35][36] Refractive lens exchange in a pediatric population leaves the child aphakic, with a higher lifetime risk for aphakic glaucoma.…”

A Modified Single-Armed Suture Technique for Traumatic Cyclodialysis Cleft with Vitreoretinal Injury

“…It can lead to a severe decrease in visual acuity due to the corneal edema, cataract, refractive change and hypotony maculopathy [ 2 , 3 , 4 ]. Intraocular surgery involving iris manipulation, such as trabeculectomy [ 5 ], trabeculotomy, phacoemulsification [ 6 ], intraocular lens implantation [ 7 ], phakic IOL removal [ 8 ], and extracapsular cataract surgery, can give rise to iatrogenic cyclodialysis. In modern surgical practice, the formation of a surgery-associated cleft is rare.…”