Cyclodialysis cleft repair with scleral band-buckle encirclage without cryopexy in the management of traumatic hypotony maculopathy

Abstract

Purpose To describe the technique of traumatic cyclodialysis cleft repair in the management of hypotony maculopathy using anterior placement of encircling scleral band-buckle. Observations A 51-year-old male who had sustained blunt trauma in the left eye two months prior to presentation in the clinics, presented with visual acuity of 20/200, a persistent cyclodialysis cleft with hypotony maculopathy and intraocular pressure (IOP) of 6 mm Hg. A silicone band-buckle was passed 360°; with its anterior edge hugging the insertion of rectus muscles along the ‘spiral of Tillaux’. Post-operative course showed closure of the cleft with an IOP of 20 mm Hg at day 4. Patient underwent cataract extraction with intraocular lens implantation at two months and improved to 20/40 at the last follow up visit with a normal IOP. Conclusion and Importance We successfully managed a case of hypotony maculopathy due to persistent cyclodialysis cleft using a circumferential band buckle. We avoided the use of cryopexy to avoid the potential risk of inflammation - further worsening choroidal effusion and rare occurrence of suprachoroidal hemorrhage.

Retina-sparing suprachoroidal intraocular foreign body resulting in cyclodialysis cleft

“… 8 Karkhur et al describe a novel technique in repairing a post-traumatic CDC with anterior scleral band-buckle encirclage without cryotherapy. 17 Photocoagulation was unsuccessful in our patient due to light pigmentation of the ciliary body and sizeable gap between the ciliary body and sclera. In one series, surgical closure was necessary in 38.9% of patients that failed laser therapy.…”