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Abstract #54654 Published in IGR 15-3
Long-term outcomes following the surgical repair of traumatic cyclodialysis clefts
Agrawal P; Shah PEye 2013; 27: 1347-1352
PURPOSE: To evaluate the long-term visual prognosis and intraocular pressure (IOP) control following direct and indirect cycloplexy for the surgical treatment of traumatic cyclodialysis clefts. METHODS: Retrospective consecutive case series of 17 eyes of 17 patients. All eyes showing signs of ocular hypotony were treated with either cleft cyclocryotherapy and/or direct surgical cycloplexy. Cycloplexy was performed by directly suturing the ciliary body to the scleral spur under a double-lamellar limbal-based scleral flap. The main outcome measures were IOP, best-corrected visual acuity (BCVA), and the occurrence of postoperative complications. RESULTS: The cyclodialysis clefts were post-traumatic in all the 17 eyes and extended for 2.1±1.6 clock-hours (range, 0.5-6 clock-hours). The mean follow-up time was 43.7±24.6 months (range, 12-110 months). Preoperatively, the mean IOP was 6.9±4.0 mm Hg (range, 2-14 mm Hg). Postoperatively, painful reversible IOP spikes of up to 70 mm Hg developed in 13 eyes. The final mean postoperative IOP was 12.2±4.1 mm Hg with no cases of secondary glaucoma. Preoperatively, BCVA was 6/12 or better in 4 eyes (24%), which rose to 12 eyes (71%) at final follow-up. Of the 12 patients who underwent direct cycloplexy, 75% achieved a final BCVA of 6/12 or better. There were no serious complications related to direct cycloplexy, including suprachoroidal haemorrhage or endophthalmitis. CONCLUSIONS: Successful cyclodialysis cleft repair can lead to a good long-term visual prognosis and stable IOP control, even in cases with a protracted history of ocular hypotony.Eye advance online publication, 30 August 2013; doi:10.1038/eye.2013.183.
1] University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK [2] Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Full articleClassification:
12.11 Cyclodialysis (Part of: 12 Surgical treatment)
9.4.11.5 Glaucomas associated with vitreoretinal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
