Non-invasive monitoring of cyclodialysis cleft using anterior segment optical coherence tomography and its role in informing clinical treatment decisions

Berk, Thomas A.; Peretz, Daniel; Mofti, Alaa; Marchais, Béatrice Des; Saheb, Hady

doi:10.1016/j.ajoc.2022.101410

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…However, visualization can be difficult in a soft eye or eyes with a shallow anterior chamber. Newer imaging modalities, such as AS-OCT in our case, serve as complementary tools to the diagnosis and monitoring of CDC [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Closure of Cyclodialysis Cleft in a Case of Normal-Tension Glaucoma Post Ab-Interno Trabeculotomy

Huang¹,

Tseng²

2022

Cureus

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A cyclodialysis cleft (CDC) is the detachment of longitudinal ciliary muscle from scleral spur, causing an unusual communication between anterior chamber and suprachoroidal space, resulting in possible hypotony. We report a case of a 63-year-old woman with normal-tension glaucoma (NTG), who developed a shallow anterior chamber with relatively low intraocular pressure (IOP, 6-8 mmHg) after combined ab-interno trabeculotomy and phacoemulsification. Her vision reached good (20/20) with the mild myopic shift. After detecting subtle signs of clinical hypotony, CDC was confirmed and monitored using anterior segment optical coherence tomography. Five months after surgery, she encountered an episode of eye pain, with transient IOP elevation and deepening of the anterior chamber. Spontaneous closure of CDC was suspected and confirmed gonioscopically. To the best of our knowledge, this is the first case to describe the clinical course of spontaneous CDC closure in a patient with NTG after ab-interno trabeculotomy. It is advisable to inform the patient about potential IOP spike after spontaneous closure once CDC is diagnosed.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Closure of Cyclodialysis Cleft in a Case of Normal-Tension Glaucoma Post Ab-Interno Trabeculotomy

Huang¹,

Tseng²

2022

Cureus

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“…So we need to pay serious attention to possibility of ciliary body detachment and other emergencies such as scleral rupture, angle recession etc. For these cases, UBM and anterior OCT can provide direct and clear images to check out some "hidden" ciliary detachments and make timely treatment possible [16,20]. Four patients in this study with serious posterior injury were diagnosed by UBM which laid a foundation for correct treatment.…”

Section: Discussionmentioning

confidence: 99%

Effect of Direct Cyclopexy for Traumatic Cyclodialysis Cleft: A Retrospective Clinical Study

Wang,

JIANG,

2024

Preprint

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Purpose To evaluate the clinical effect of direct cyclopexy for treatment of traumatic cyclodialysis cleft. Methods This is a retrospective case series study. Patients with traumatic cyclodialysis cleft who were treated by direct cyclopexy and had complete medical records in Tianjin Eye Hospital from Feb, 2021 to Aug, 2022 were selected. The detailed characteristics of 23 cases were analyzed. Preoperative and postoperative visual acuity, intraocular pressure (IOP), and extent of ciliary detachment of the patients were recorded. All the patients were followed up 6months. Results 19 of 23 cases underwent single direct cyclopexy, the other 4 cases with severe posterior section damage received direct cyclopexy combined with vitrectomy, suprachoroidal drainage etc. After operation, 95.65% patients (22/23) successfully reset the ciliary body, including 4 cases receiving combined operations, which has significant difference in statistical significance compared with that of preoperative(P < 0.01). The mean preoperative IOP was 6.48 ± 1.62 mmHg and it has a different degree of rebound in 21 cases reaching 13.29 ± 2.11 mmHg on 6 months after operation, including 6 cases of transient high intraocular pressure (> 21mmHg). The difference has statistical significance (t = 12.74, P < 0.01). Best corrected visual acuity was increased from preoperatively 0.60 ± 0.21 logMAR to 0.38 ± 0.26 log MAR postoperatively, in which the vision > 0.3 reached 65.2% and the difference has statistical significance(t = 5.04, P < 0.01). Conclusions According to different condition, direct cyclopexy combined with or without vitrectomy is an effective method for treatment of traumatic ciliary body detachment.

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“…Inadvertent clefts can theoretically occur during any intraocular surgery, and they have been reported as complications of cataract surgery, goniotomy surgery, minimally invasive glaucoma surgery, and surgical peripheral iridectomy, just to name a few. [7][8][9][10][11][12][13][14][15] In the past, clefts were created intentionally to treat glaucoma; however, this treatment is now obsolete. 7 The prevalence of cyclodialysis clefts post-trauma is around 2% to 35%.…”

Section: Introductionmentioning

confidence: 99%

“… 4–6 The majority of cyclodialysis clefts are induced by ocular trauma; however, iatrogenic causes may also occur. Inadvertent clefts can theoretically occur during any intraocular surgery, and they have been reported as complications of cataract surgery, goniotomy surgery, minimally invasive glaucoma surgery, and surgical peripheral iridectomy, just to name a few 7–15 . In the past, clefts were created intentionally to treat glaucoma; however, this treatment is now obsolete 7 …”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, benefits of anterior segment OCT over UBM include: (1) it requires no contact and is painless, (2) it is an easier technique to perform and is less operator dependent, and (3) it produces higher-resolution images 23 . Using anterior segment OCT, Berk et al 15 described 2 cleft cases where serial imaging was able to track anatomic improvement and eventual cleft closure.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Guide to the Repair of Traumatic Cyclodialysis Clefts: Medical, Laser, and Surgical Treatment

Castillejos,

Chen

2024

International Ophthalmology Clinics

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Non-invasive monitoring of cyclodialysis cleft using anterior segment optical coherence tomography and its role in informing clinical treatment decisions

Cited by 5 publications

References 14 publications

Spontaneous Closure of Cyclodialysis Cleft in a Case of Normal-Tension Glaucoma Post Ab-Interno Trabeculotomy

Spontaneous Closure of Cyclodialysis Cleft in a Case of Normal-Tension Glaucoma Post Ab-Interno Trabeculotomy

Effect of Direct Cyclopexy for Traumatic Cyclodialysis Cleft: A Retrospective Clinical Study

A Guide to the Repair of Traumatic Cyclodialysis Clefts: Medical, Laser, and Surgical Treatment

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