Indirect Cyclopexy for Repair of Cyclodialysis Clefts

Feiler, Daniel; Browne, Andrew; Rachitskaya, Aleksandra; Taban, Mehran; Sonnie, Christine; Hayden-Loreck, Brandy; Sharma, Sumit; Sears, Jonathan E.

doi:10.1097/iae.0000000000002091

Cited by 8 publications

(7 citation statements)

References 15 publications

(30 reference statements)

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“…For large cyclodialysis clefts or failure of conservative treatment, surgical intervention is required. Surgical methods include direct or indirect cyclopexy via sclera incision [17, 18], sulcus-fixated Cionni ring and posterior chamber intraocular lens (PCIOL) implantation [19], and vitrectomy combined with gas or silicone oil endotamponade [20]. The success rate varies differently.…”

Section: Discussionmentioning

confidence: 99%

Continuous ab interno repairing of traumatic cyclodialysis cleft using a 30-gauge needle in severe ocular trauma: a clinical observation

Cai

2019

BMC Ophthalmol

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BackgroundTo investigate the efficacy and safety of continuous ab interno repairing of traumatic cyclodialysis cleft in severe ocular trauma using a 30-gauge (G) needle.MethodsFifteen patients (15 eyes) with traumatic cyclodialysis cleft admitted to the ocular trauma department of our hospital from July 2014 to December 2018 were included in this study. After the bulbar conjunctiva corresponding to the ciliary body was incised along the corneal limbus, an incision was made along the corneal limbus on the opposite side. A 30G needle with a 10–0 suture entered the anterior chamber from the incision and passed through the ciliary body with clefts and the sclera to fixate the ciliary body on the sclera wall with continuous mattress suture. The best corrected visual acuity (BCVA) and intraocular pressure (IOP) were observed preoperatively and postoperatively. In vivo ultrasound biomicroscopy (UBM) was performed to observe closure of cyclodialysis cleft before and after surgery.ResultsFifteen patients successfully underwent continuous mattress suture for repair of cyclodialysis cleft. No bleeding and suture breakage were reported during surgery. After surgery, the UBM during follow-up showed satisfactory closure of the cyclodialysis cleft. The BCVA and IOP were improved to different degrees. The difference between the preoperative IOP and the postoperative IOP (1 week) was statistically significant (preoperative: 6.49 ± 0.98 mmHg, postoperative: 16.17 ± 4.65 mmHg, t = − 8.43, P < 0.05), and the difference between the preoperative IOP and the postoperative IOP (1 month) was also statistically significant (preoperative: 6.49 ± 0.98 mmHg, postoperative: 14.63 ± 3.63 mmHg, t = − 8.38, P < 0.05). Duration of outpatient follow-up was 3 to 12 months. No complications, including exposed knots, loose sutures, decompensation of corneal endothelium, sympathetic ophthalmia, endophthalmitis and choroidal detachment, were reported.ConclusionContinuous ab interno repairing of traumatic cyclodialysis cleft in severe ocular trauma using a 30G needle is a safe and effective procedure with simple operation, little tissue damage and few complications.

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Section: Discussionmentioning

confidence: 99%

Continuous ab interno repairing of traumatic cyclodialysis cleft using a 30-gauge needle in severe ocular trauma: a clinical observation

Cai

2019

BMC Ophthalmol

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“…4 Indirect Cycloplexy (Exocyclopexy) Indirect cycloplexy is a newer surgical technique, where a suture is initially passed through the cornea adjacent to the cleft into the iris root and ciliary body and then back through the sclera. [55][56][57] No scleral incisions are made with this technique. It may be theoretically safer than traditional direct cycloplexy; however, risks include pupillary peaking and permanent angle deformation which could lead to secondary glaucoma.…”

Section: Surgical Treatment Of Cyclodialysis Cleftsmentioning

confidence: 99%

“…Indirect cycloplexy is a newer surgical technique, where a suture is initially passed through the cornea adjacent to the cleft into the iris root and ciliary body and then back through the sclera 55–57 . No scleral incisions are made with this technique.…”

Section: Introductionmentioning

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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“…modified this technique to make it entirely ‘trans‐scleral’, starting 3.5 mm posterior to limbus, involving the detached CB and passing out through the sclera 1.5 mm behind the limbus (Feiler et al. ). Though this appears to spare the pupil and the angle, this is a blind technique and needle exits strictly at the marked position would be difficult.…”

Section: Management Based On Current Evidence‐based Knowledgementioning

confidence: 99%

Cyclodialysis: an updated approach to surgical strategies

Selvan

Gupta

2019

Acta Ophthalmologica

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Cyclodialysis is a rare occurrence and is difficult to treat, it being concealed behind the iris. In view of the varied success outcomes of the different available surgical repair techniques, there is at present no clear consensus regarding their management strategies. Through this article, we intend to appraise the established surgical methods, update the novel techniques in vogue, discuss their outcomes and propose a uniform system to codify these corrective techniques. They have been reclassified under the terms 'exocyclopexy', 'endocyclopexy', 'exocyclotamponade' and 'endocyclotamponade' based on the approach used and their mode of action. The ab-interno techniques (endocyclopexy and endocyclotamponade) are easier to perform, offer good success rates and better safety profiles such that they may be considered as a viable alternative to the standard exocyclopexy in either cataractous or pseudophakic and aphakic eyes.

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Indirect Cyclopexy for Repair of Cyclodialysis Clefts

Cited by 8 publications

References 15 publications

Continuous ab interno repairing of traumatic cyclodialysis cleft using a 30-gauge needle in severe ocular trauma: a clinical observation

Continuous ab interno repairing of traumatic cyclodialysis cleft using a 30-gauge needle in severe ocular trauma: a clinical observation

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

Cyclodialysis: an updated approach to surgical strategies

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