Diagnosis of Traumatic Cyclodialysis by Ultrasound Biomicroscopy

Rc, Gentile; Cj, Pavlin; Liebmann, J. M.; Easterbrook, Michael; Tello, Celso; Foster, F. Stuart; Ritch, Robert

doi:10.3928/1542-8877-19960201-03

Cited by 53 publications

(6 citation statements)

References 30 publications

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“…UBM and intraoperative use of dyes are useful tools for accurate diagnosis and management of challenging glaucoma drainage device revision. UBM has been described to be e cacious to diagnose peritubular leak and cyclodialysis cleft (7)(8)(9). Meanwhile, intra-operative use of trypan blue has been used to assess intracameral ow and investigate causes of post-operative hypotony (10,11).…”

Section: Discussionmentioning

confidence: 99%

Ocular hypotony precipitated by Tube Trimming in a uveitic eye with Descemet Membrane Stripping Automated Endothelial Keratoplasty and prior tube revision

Lee

Chan

Georgoulas

2023

Preprint

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Background To describe ocular hypotony precipitated by trimming of a glaucoma shunt tube in an eye with uveitic glaucoma, a failed Descemet Membrane Stripping Automated Endothelial Keratoplasty (DSAEK) and prior tube revisions.Case Presentation: A patient in her thirties with uveitic glaucoma of the right eye had endothelial decompensation of a DSAEK graft secondary to corneal endothelial touch from two previous glaucoma drainage implants. She underwent ab-interno tube trimming and subsequently developed postoperative hypotony with intraocular pressure (IOP) of 2 mm Hg. Intraoperative Trypan blue was effectively utilized to make the diagnosis of an over-filtering glaucoma drainage device, despite the presence of an intraluminal stent. Tube ligation was performed, and the IOP increased to 8 mmHg. IOP has remained stable at a 6-month follow-up review.Conclusions Glaucoma shunt tube trimming may be associated with development of ocular hypotony despite minimal manipulation or removal of the associated intraluminal stent in non-valved glaucoma drainage devices. Trypan blue may be considered as a useful diagnostic adjunct for determining the underlying cause of hypotony in such cases.

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Section: Discussionmentioning

confidence: 99%

Ocular hypotony precipitated by Tube Trimming in a uveitic eye with Descemet Membrane Stripping Automated Endothelial Keratoplasty and prior tube revision

Lee

Chan

Georgoulas

2023

Preprint

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“…2B and 3). 19,25,26 After laser or surgical cleft closure, UBM can also be used to confirm successful closure of the cyclodialysis cleft. 19 An even newer modality, anterior segment OCT, can correlate well with UBM.…”

Section: Diagnosis Of Cyclodialysis Cleftsmentioning

confidence: 99%

A Guide to the Repair of Traumatic Cyclodialysis Clefts: Medical, Laser, and Surgical Treatment

Castillejos,

Chen

2024

International Ophthalmology Clinics

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“…The eye cup should be inserted with minimal pressure on the globe and filled with a sterile coupling medium. 34 Moreover, it is important to note that examiners should be gentle during UBM examinations to prevent the wound from reopening, and antibiotic eyedrops should always be administered at the end of examination. However, clinicians should consider that UBM has only a 5.0-mm penetration depth.…”

Section: B-scan (Nmentioning

confidence: 99%

Efficiency of different imaging methods in detecting ocular foreign bodies

Cheng,

Zhao,

Chen

et al. 2023

Medical Physics

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BackgroundOcular foreign bodies (OFBs) are a relatively common occurrence in ocular injuries, and a severe risk factor for vision disorders. They are notoriously challenging to identify and localize precisely to allow surgical removal, even with the most recent technological advancements.PurposeTo compare the efficiency of different imaging methods in detecting and localizing OFBs.MethodsWe conducted a retrospective analysis of the medical records of patients with OFBs, detected by ultrasound biomicroscopy (UBM) and confirmed during surgery. Patients who presented to our medical center between January 2016 and January 2022 and also underwent computed tomography (CT), X ray, and/or ocular B‐scan ultrasonography (B‐scans) were selected.ResultsThis study included 134 patients with a history of ocular trauma and OFBs (mean age: 47.25 years, range: 8–78). The mean time interval from injury to UBM examination was 36.31 months (range: 0.2–120 months). Most OFBs were metallic (51.82%) or plant‐based (25.37%); 22.39% of them were located in the sclera, 26.87% in the anterior chamber, and 23.88% in the ciliary body and iris. OFBs ranged in size from 0.10 to 6.67 mm (mean: 1.15 ± 1.10 mm). B‐scans identified OFBs in 37 of the 119 patients examined (31.09%); CT in 52 of 84 patients (61.90%); and radiography in 29 of 50 patients (58.00%). Univariate and multivariate analyses determined that both CT and radiography showed low detection rates for plant‐based versus non‐plant‐based OFBs (CT: p < 0.001; radiography: p = 0.007), small particles (<1.00 mm vs. >1.00 mm; CT: p = 0.001, radiography: p = 0.024), and with eyeball wall locations (vs. intraocular; CT: p < 0.001, radiography: p = 0.021). Similarly, B‐scans were less efficient for plant‐based and eyeball wall‐located OFBs (both p = 0.001), whereas the difference based on dimensions was not significant (p = 0.118).ConclusionsCT, radiography, and B‐scans showed lower detection rates for plant‐based, small, and eyeball wall‐located OFBs. Our findings strongly suggest that UBM could be a more adequate imaging modality when such OFBs are suspected.

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Diagnosis of Traumatic Cyclodialysis by Ultrasound Biomicroscopy

Cited by 53 publications

References 30 publications

Ocular hypotony precipitated by Tube Trimming in a uveitic eye with Descemet Membrane Stripping Automated Endothelial Keratoplasty and prior tube revision

Ocular hypotony precipitated by Tube Trimming in a uveitic eye with Descemet Membrane Stripping Automated Endothelial Keratoplasty and prior tube revision

A Guide to the Repair of Traumatic Cyclodialysis Clefts: Medical, Laser, and Surgical Treatment

Efficiency of different imaging methods in detecting ocular foreign bodies

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