Intrascleral sewing-machine technique: A Grooveless/flapless cyclopexy technique for large traumatic Cyclodialysis cleft repairs in pars plana vitrectomy

Huang, Liuhui; Zhou, Qi Tony; Jin, Haiying

doi:10.1097/iae.0000000000002772

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…This procedure aims to preserve the crystalline lens, unlike other surgical methods advocated by some surgeons, which often involve cataract removal or a pars plana vitrectomy. 7,8 Although certain cleft closures can be accomplished through an anterior chamber approach, it must be borne in mind that such procedures are predominantly suitable for pseudophakic patients or patients undergoing concomitant cataract surgery. [9][10][11][12] Our phakic patient developed a distinctive satellite-like cataract, and cataract surgery was a vital option.…”

Section: Discussionmentioning

confidence: 99%

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Challenging diagnosis and repair of an extensive cyclodialysis cleft

Braudo,

Neuman,

Shitrit

et al. 2024

JCRS Online Case Rep

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Introduction: This report describes a challenging case involving the diagnosis and surgical repair of an extensive cyclodialysis cleft (CDC) in a young, phakic patient. Patient and Clinical Findings: A 25-year-old man presented with ocular pain, visual impairment, eyelid hematoma, subconjunctival hemorrhage, and Berlin edema after blunt trauma to the right eye. Initial conservative treatment with medications was converted to surgery due to hypotony-induced maculopathy. Diagnosis, Intervention, and Outcomes: Ultrasound biomicroscopy (UBM) and gonioscopy revealed extensive supraciliary and suprachoroidal fluid and a CDC whose dimensions were inconclusive. However, consequent intraoperative UBM provided precise real-time anatomical evidence of an extensive CDC extending 8 clock hours and mandating closure with a direct cycloplexy approach. Layered scleral dissection and direct suturing of the ciliary body to the sclera were performed with 8-0 nylon sutures, resulting in CDC resolution, supraciliary and suprachoroidal fluid absorption, visual acuity improvement, and intraocular pressure stabilization. Conclusions: This case highlights the innovative use of intraoperative UBM as a critical tool, offering real-time guidance in managing an extensive CDC. The successful closure and improved visual outcomes in this case further validate the efficacy of direct cycloplexy for extensive CDCs.

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Section: Discussionmentioning

confidence: 99%

“…This procedure aims to preserve the crystalline lens, unlike other surgical methods advocated by some surgeons, which often involve cataract removal or a pars plana vitrectomy. 7,8…”

Section: Discussionmentioning

confidence: 99%

Challenging diagnosis and repair of an extensive cyclodialysis cleft

Braudo,

Neuman,

Shitrit

et al. 2024

JCRS Online Case Rep

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“…There is no large conjunctival or scleral incision, which minimizes surgical trauma. 17,18 (4) As shown in Figure 2, E, the suture is knotted at both ends, which allows the surgeon to adjust the tension at both ends to center the IOL before fixation. (5) The second knot is approximately 3 mm from the first, allowing the surgeon to anchor the suture ends within the sclera without creating a scleral flap, capsule, or groove.…”

Section: Discussionmentioning

confidence: 99%

Single-string, closed-loop fixation modification to reposit a dislocated triple-looped haptic intraocular lens

Qian

Ying

et al. 2022

J Cataract Refract Surg

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A technique using the single-string, closed-loop fixation method to reposit dislocated triple-looped haptic intraocular lens (IOL)–capsular bag complex is described. The long needle or curved needle with a 10-0/8-0 polypropylene suture and a 27/30-gauge needle were used as the guide needle to pass through the fenestrated haptics twice. The scleral interlaminar course was used as the fixed point. Last, a fixation knot was created in the sclerotomy by the 2 ends of the thread to close the suture loop for IOL fixation. Another knot was created about 2 to 3 mm from the exit point and was intrasclerally anchored by the aid of the attached needle. 4 eyes from 4 consecutive patients were studied retrospectively; during all follow-up visits, the IOLs were well centered and stable, and no suture erosion, hypotony, scleral atrophy, chronic inflammation, retinal tears, and/or detachments were observed.

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“…Another approach adopted in this technique for minimizing surgical trauma is intrascleral manipulation, similar to our published techniques [ 15 , 17 , 18 ]. The suture was passed intrasclerally from the fist fixation site to the second one with the aid of an attached curved needle.…”

Section: Discussionmentioning

confidence: 99%

Intraocular Suture Looping Technique for Flapless Four-Point Refixation of Dislocated Intraocular Lenses

Zhao

Jin

2021

Journal of Ophthalmology

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Purpose. To describe a flapless/grooveless technique for four-point refixation of a dislocated intraocular lens (IOL) with four fenestrated haptics. Methods. An intraocular suture looping technique was performed with the assistance of two 27-gauge needles. A looping needle was passed into the eye through paracentesis and was used to loop both fenestrated haptics on the same side with an 8–0 polypropylene thread. A guiding needle was used to guide the looping needle out of the eye at the scleral fixation sites. After looping each pair of fenestrated haptics on nasal/temporal sides with 8–0 polypropylene sutures, the IOL was refixated by definitive knotting. The exterior suture ends were buried into the sclera without the creation of scleral flaps/grooves. Results. The technique was employed in four eyes (three patients). The mean postoperative follow-up period was 13.8 ± 2.2 months. Postoperatively, the IOLs of all the eyes remained well positioned and stable. The postoperative visual acuities of all the eyes were improved. No suture erosion, hypotony, scleral atrophy, chronic inflammation, retinal tears, and/or detachments were observed within the follow-up period. Conclusion. The present technique provides minimal surgical invasion for the transscleral refixation of a dislocated IOL with four fenestrated haptics.

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Intrascleral sewing-machine technique: A Grooveless/flapless cyclopexy technique for large traumatic Cyclodialysis cleft repairs in pars plana vitrectomy

Cited by 4 publications

References 19 publications

Challenging diagnosis and repair of an extensive cyclodialysis cleft

Challenging diagnosis and repair of an extensive cyclodialysis cleft

Single-string, closed-loop fixation modification to reposit a dislocated triple-looped haptic intraocular lens

Intraocular Suture Looping Technique for Flapless Four-Point Refixation of Dislocated Intraocular Lenses

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