Surgical repair of large cyclodialysis clefts

Eur J Ophthalmol. 2017 May 11;27(3):382-385. doi: 10.5301/ejo.5000868. Epub 2016 Sep 13.


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.

MeSH terms

  • Adolescent
  • Adult
  • Ciliary Body / diagnostic imaging
  • Ciliary Body / injuries
  • Ciliary Body / surgery*
  • Eye Injuries / complications*
  • Eye Injuries / diagnosis
  • Female
  • Gonioscopy
  • Humans
  • Intraocular Pressure
  • Male
  • Microscopy, Acoustic
  • Middle Aged
  • Ocular Hypotension / etiology
  • Ocular Hypotension / physiopathology
  • Ocular Hypotension / surgery*
  • Ophthalmologic Surgical Procedures / methods*
  • Tomography, Optical Coherence
  • Tonometry, Ocular
  • Visual Acuity*
  • Wounds, Nonpenetrating / complications*
  • Wounds, Nonpenetrating / diagnosis
  • Young Adult