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Abstract

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.

Patients

Our patient is a 43-year-old woman who suffered a blunt trauma 9 months ago from an air-bag blunt in a car accident.

Methods

Technique report.

Results

Two weeks post-surgery, there has been an elevation in intraocular pressure (IOP), and the cyclodialysis has been resolved. Additionally, signs of macular hypotony, such as optic nerve head edema and vascular tortuosity, have disappeared. As anticipated, the disappearance of chorioretinal folds occurred later but has also been observed. Furthermore, the best corrected visual acuity has been improved and the induced hyperopia has been corrected from +5 (−1.75 × 20°) to +1.5 (−1.75 × 20°).

Conclusions

Combined sewing machine technique cyclopexy with transscleral diode cyclophotocoagulation for complete post-traumatic cyclodialysis could be an alternative surgical improvement to both direct and indirect cyclopexy. It entails fewer complications, such as endophthalmitis, and offers favorable aesthetic outcomes along with enhanced intraoperative visualization.

Keywords

Cyclopexy hypotony sewing machine technique ab interno cyclodialysis

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References

Pujari

Selvan

Behera

, et al. The probable mechanism of traumatic angle recession and cyclodialysis. J Glaucoma 2020; 29: 67–70. doi:https://doi.org/10.1097/IJG.0000000000001358

Wang

Thau

Levin

, et al. Ocular hypotony: a comprehensive review. Surv Ophthalmol 2019; 64: 619–638. doi:https://doi.org/10.1016/J.SURVOPHTHAL.2019.04.006

González-Martín-Moro

Castro-Rebollo

Zarallo-Gallardo

, et al. Ciclodiálisis traumática tratada con láser ciclodiodo transescleral: evolución de la exploración del segmento anterior y posterior. Arch Soc Esp Oftalmol 2017; 92: 386–389. doi:https://doi.org/10.1016/j.oftal.2016.12.013

Mardelli

. Closure of persistent cyclodialysis cleft using the haptics of the intraocular Lens. Am J Ophthalmol 2006; 142: 676–678. doi:https://doi.org/10.1016/j.ajo.2006.05.027

Ioannidis

Barton

. Cyclodialysis cleft: causes and repair. Curr Opin Ophthalmol 2010; 21: 150–154. doi:https://doi.org/10.1097/ICU.0b013e3283366a4d

Jing

Chen

, et al. Cionni-modified capsular tension ring for surgical repair of cyclodialysis after trabeculectomy: a case report. BMC Ophthalmol 2017; 17: 1–6. doi:https://doi.org/10.1186/s12886-017-0582-4

Sen

Parija

Nayak

. Hypotony maculopathy: a surgeon’s nightmare. BMJ Case Rep 2019; 12: 10–12. doi:https://doi.org/10.1136/bcr-2019-231272

Huang

Wang

, et al. Cyclopexy versus vitrectomy combined with intraocular tamponade for treatment of cyclodialysis. Int J Ophthalmol 2013; 6: 187–192. doi:https://doi.org/10.3980/j.issn.2222-3959.2013.02.16

Vannas

Bjorkenheim

. On hypotony following cyclodialysis and its treatment. Acta Ophthalmol 1952; 30: 63–64.

10.

Ioannidis

Bunce

Barton

. The evaluation and surgical management of cyclodialysis clefts that have failed to respond to conservative management. Br J Ophthalmol 2014; 98: 544–549. doi:https://doi.org/10.1136/bjophthalmol-2013-303559

11.

Chadha

Lamba

Belyea

, et al. Indirect cyclopexy for treatment of a chronic traumatic cyclodialysis cleft with hypotony. Clin Ophthalmol 2014; 8: 591–594. doi:https://doi.org/10.2147/OPTH.S55938

12.

Sen

Joshi

Kashikar

, et al. Novel technique for traumatic cyclodialysis repair with phacoemulsification and cionni's ring implantation. Indian J Ophthalmol 2019; 67: 1748–1750. doi: https://doi.org/10.4103/ijo.IJO_394_19

13.

Gupta

Selvan

Shakrawal

, et al. One-step management of post-traumatic triple dialysis using two rings. Eur J Ophthalmol 2019; 29: NP9–NP13. doi: https://doi.org/10.1177/1120672118803520

14.

Hoerauf

Roider

Laqua

. Treatment of traumatic cyclodialysis with vitrectomy, cryotherapy, and gas endotamponade. J Cataract Refract Surg 1999; 25: 1299–1301. doi:https://doi.org/10.1016/S0886-3350(99)00160-1

15.

Ormerod

Baerveldt

Sunalp

, et al. Management of the hypotonous cyclodialysis cleft. Ophthalmology 1991; 98: 1384–1393. doi:https://doi.org/10.1016/S0161-6420(91)32121-3

16.

Maumenee

Stark

. Management of persistent hypotony after planned or inadvertent cyclodialysis. Am J Ophthalmol 1971; 71: 320–327. doi:https://doi.org/10.1016/0002-9394(71)90405-3

17.

Krohn

. Cryotherapy in the treatment of cyclodialysis cleft induced hypotony. Acta Ophthalmol Scand 1997; 75: 96–98. doi:https://doi.org/10.1111/j.1600-0420.1997.tb00260.x

18.

Gupta

Selvan

Gupta

. Single-suture single-knot ab interno cyclopexy for extensive posttraumatic cyclodialysis: modified sewing machine technique. J Cataract Refract Surg 2019; 45: 3–7. doi:https://doi.org/10.1016/j.jcrs.2018.08.031

19.

Amini

Razeghinejad

. Transscleral diode laser therapy for cyclodialysis cleft induced hypotony. Clin Exp Ophthalmol 2005; 33: 348–350. doi:https://doi.org/10.1111/j.1442-9071.2005.01008.x

20.

Brown

Mizen

. Transscleral diode laser therapy for traumatic cyclodialysis cleft. Ophthalmic Surg Lasers 1997; 28: 313–317.

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Combined sewing machine technique cyclopexy With transscleral diode cyclophotocoagulation for complete posttraumatic cyclodialysis

Abstract

Purpose

Patients

Methods

Results

Conclusions

Keywords

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References

Supplementary Material