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Surgical repair of large cyclodialysis clefts

Abstract

Purpose

To describe a new surgical technique to effectively close large (>180 degrees) cyclodialysis clefts.

Methods

Our method involves the use of procedures commonly associated with repair of retinal detachment and complex cataract extraction: phacoemulsification with placement of a capsular tension ring followed by pars plana vitrectomy and gas tamponade with light cryotherapy. We also used anterior segment optical coherence tomography (OCT) as a noninvasive mechanism to determine the extent of the clefts and compared those results with ultrasound biomicroscopy (UBM) and gonioscopy.

Results

This technique was used to repair large cyclodialysis clefts in 4 eyes. All 4 eyes had resolution of hypotony and improvement of visual acuity. One patient had an intraocular pressure spike requiring further surgical intervention. Anterior segment OCT imaging in all 4 patients showed a more extensive cleft than UBM or gonioscopy.

Conclusions

This technique is effective in repairing large cyclodialysis clefts. Anterior segment OCT more accurately predicted the extent of each cleft, while UBM and gonioscopy both underestimated the size of the cleft.

Eur J Ophthalmol 2017; 27(3): 382 - 385

Article Type: SURGICAL TECHNIQUE

DOI:10.5301/ejo.5000868

Authors

Jacob B. Gross, Garvin H. Davis, Nicholas P. Bell, Robert M. Feldman, Lauren S. Blieden

Article History

Disclosures

Financial support: Supported in part by National Eye Institute Vision Core Grant P30EY010608, a Challenge Grant from Research to Prevent Blindness to the McGovern Medical School at UTHealth, and the Hermann Eye Fund.
Conflict of interest: None of the authors has conflict of interest with this submission.
Meeting presentation: Previously presented in part as a poster at the 24th American Glaucoma Society Annual Meeting, February 27-March 2, 2014, Washington, DC, USA.

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Authors

Affiliations

  •  Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX - USA
  •  Robert Cizik Eye Clinic, Houston, TX - USA

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