Ultrasonic biomicroscopic evaluation of cyclodialysis before and after direct cyclopexy

Arch Ophthalmol. 2008 Sep;126(9):1222-5. doi: 10.1001/archopht.126.9.1222.


Objectives: To investigate the clinical manifestations and surgical prognoses after direct cyclopexy in patients with traumatic cyclodialysis according to the cleft extent as determined by ultrasound biomicroscopy (UBM).

Methods: A detailed ophthalmologic examination, which included gonioscopy and UBM, was performed before and after direct cyclopexy in 32 eyes of 31 patients with traumatic cyclodialysis clefts.

Results: Cyclodialysis clefts were accurately diagnosed and delineated in all 32 eyes using UBM. Cyclodialysis resulted in hypotony with a mean intraocular pressure of 3.2 mm Hg irrespective of cleft size. On A-scan ultrasonography, mean (SD) preoperative and postoperative lens thicknesses were 4.4 (0.4) mm (range, 3.71-4.92 mm) and 4.1 (0.4) mm (range, 3.42-4.57 mm), respectively, and mean (SD) preoperative and postoperative axial lengths were 23.2 (0.7) mm (range, 21.91-24.57 mm) and 23.6 (0.7) mm (range, 22.47-24.56 mm), respectively. The larger a cleft was, the longer it took for a postoperatively elevated intraocular pressure to normalize after direct cyclopexy. Postoperative visual acuities were significantly better than preoperative values, even when direct cyclopexy was performed 54 months after trauma.

Conclusions: Even small clefts usually resulted in hypotony and visual prognosis was better after cyclopexy, even in cases with a protracted history. Larger clefts need longer postoperative follow-up to check for intraocular pressure normalization after direct cyclopexy.

MeSH terms

  • Adolescent
  • Adult
  • Ciliary Body / diagnostic imaging*
  • Ciliary Body / injuries
  • Ciliary Body / surgery
  • Cryosurgery*
  • Eye Injuries / diagnostic imaging*
  • Eye Injuries / surgery
  • Female
  • Gonioscopy
  • Humans
  • Intraocular Pressure
  • Male
  • Microscopy, Acoustic
  • Middle Aged
  • Ocular Hypotension / diagnosis
  • Ophthalmologic Surgical Procedures
  • Rupture
  • Sclera / diagnostic imaging*
  • Sclera / injuries
  • Sclera / surgery
  • Uveal Diseases / diagnostic imaging*
  • Uveal Diseases / surgery
  • Visual Acuity