Abstract
This is a retrospective case series of 4 patients with traumatic cyclodialysis cleft (CC) with features of hypotony and posterior segment manifestations of blunt trauma who were treated using encirclage and trans scleral cryoptherapy along with vitrectomy. Encirclage was placed anteriorly in order to support the cleft. There was closure of cleft and improvement in Intra ocular pressure (IOP) in all cases. Thus the identification and treatment of CC with encirclage in cases with varied posterior manifestation of trauma can lead to good anatomical and visual restoration.
Highlights
Blunt trauma can have varied manifestations amongst which cyclodialysis cleft (CC) is there, a cleft forms once the ciliary body separates from sclera and the aqueous can freely pass from anterior chamber to suproachoroidal space
Various treatment options tried in management of CC so far are mydriatics, (Ormerod, Baerveldt, Sunalp & Riekhof, 2991) ciliochoroidal diathermy, (Maumenee & Stark, 1971) cyclopexy, (Kuchle & Naumann, 1995) placement of anterior scleral buckle at site of cleft, (McCannel, 1976) cryoablation to cleft to induce scarring and closure, (Mandava, Kahook, Mackenzie & Olson, 2006) argon laser photocoagulation which leads to scar formation, (Harbin, 1982) combined vitrectomy with cryotherapy and gas tamponade, (Hoerauf, Roider & Laqua, 1999) trans-scleral YAG or diode laser, (Amini & Razeghinejad, 2005) microendoscope assisted endophotocoagulation. (Saha, MacNaught & Gale, 2003)
This is for the first time in literature that encirclage was used as treatment option for CC and we describe our experience for 4 eyes
Summary
Blunt trauma can have varied manifestations amongst which CC is there, a cleft forms once the ciliary body separates from sclera and the aqueous can freely pass from anterior chamber to suproachoroidal space This leads to hypotony in eye and its sequel. IOP on second day was 2 mmHg; patient was followed up for 2 months with persistent cleft and low IOP His visual acuity deteriorated due to cataract and macular pucker. CASE NO 2: A 15 year old boy sustained trauma to left eye with cycle chain 175days back followed by diminution of vision. At presentation his BCVA was hand movement.
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