Abstract
Background Various techniques have been described for repairing cyclodialysis clefts, but there is no consensus regarding the optimal treatment. This study investigated the clinical efficacy of a novel surgical approach that is used to manage traumatic cyclodialysis. Methods We prospectively enrolled 7 patients (7 eyes) with traumatic cyclodialysis of the concomitant lens and other vitreous diseases. Ultrasound biomicroscopy was used to diagnose cyclodialysis, and all eyes underwent pars plana vitrectomy with air endotamponade. The main outcome measures were postoperative anatomical success rates, best-corrected visual acuity (BCVA), and intraocular pressure (IOP). Results All patients were male, and their age ranged from 46 to 64 years (mean: 54.3 years). After the surgical intervention, the extent of the cyclodialysis cleft ranged from 1 to 4 clock hours (mean: 2.3 clock hours) and the detached ciliary body of all cases was completely restored; the anatomical success rate was 100%. The BCVA significantly increased from 1.40 ± 0.49 to 0.42 ± 0.31 (P = 0.002). The IOP increased from 8.91 ± 1.77 to 14.67 ± 6.38, but the difference was not significant (P = 0.056). The postoperative IOP of most patients was temporarily elevated or lowered after surgery. At the last follow-up, there were still two abnormal cases, including one with ocular hypertension and one with hypotony. Conclusions This study revealed that vitrectomy with air endotamponade is an effective and minimally invasive alternative surgical approach for small traumatic cyclodialysis clefts.
Highlights
Cyclodialysis results from the separation of the longitudinal ciliary muscle fibres from the scleral spur, which leads to hypotony, a decrease in the production of aqueous fluids, and the opening of an additional drainage pathway of the aqueous humour into the suprachoroidal space
Cyclodialysis can be caused by ocular trauma or surgical injury, and gonioscopy and ultrasound biomicroscopy (UBM) are used for its diagnosis
Numerous therapeutic strategies have been reported for the treatment of cyclodialysis; the underlying mechanisms of these treatments involve the reattachment of the ciliary body to the sclera and restoration of the intraocular pressure (IOP) [3]
Summary
Cyclodialysis results from the separation of the longitudinal ciliary muscle fibres from the scleral spur, which leads to hypotony, a decrease in the production of aqueous fluids, and the opening of an additional drainage pathway of the aqueous humour into the suprachoroidal space. Vitrectomy with endotamponade is recommended for the treatment of traumatic cyclodialysis that presents with a concomitant posterior segment pathology [1]. There are no known studies that have used vitrectomy with air endotamponade to treat cyclodialysis.
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