Vitrectomy with Air Endotamponade for Traumatic Cyclodialysis

Abstract

Background. Various techniques have been described for repairing cyclodialysis clefts, but there is no consensus regarding the optimal treatment. This study investigated the clinical efficacy of a novel surgical approach that is used to manage traumatic cyclodialysis. Methods. We prospectively enrolled 7 patients (7 eyes) with traumatic cyclodialysis of the concomitant lens and other vitreous diseases. Ultrasound biomicroscopy was used to diagnose cyclodialysis, and all eyes underwent pars plana vitrectomy with air endotamponade. The main outcome measures were postoperative anatomical success rates, best-corrected visual acuity (BCVA), and intraocular pressure (IOP). Results. All patients were male, and their age ranged from 46 to 64 years (mean: 54.3 years). After the surgical intervention, the extent of the cyclodialysis cleft ranged from 1 to 4 clock hours (mean: 2.3 clock hours) and the detached ciliary body of all cases was completely restored; the anatomical success rate was 100%. The BCVA significantly increased from 1.40 ± 0.49 to 0.42 ± 0.31 (P = 0.002). The IOP increased from 8.91 ± 1.77 to 14.67 ± 6.38, but the difference was not significant (P = 0.056). The postoperative IOP of most patients was temporarily elevated or lowered after surgery. At the last follow-up, there were still two abnormal cases, including one with ocular hypertension and one with hypotony. Conclusions. This study revealed that vitrectomy with air endotamponade is an effective and minimally invasive alternative surgical approach for small traumatic cyclodialysis clefts.

Surgical outcomes of partial ciliary body direct suturing under the scleral flap for traumatic cyclodialysis cleft: A five-case series

“…[9][10][11][12][13][14][15][16][17][18][19][20] These interventions include ciliary body suturing (cyclopexy), [12][13][14] cyclocryotherapy, 10,11 laser photocoagulation, 3,15 encircling, 16,17 intraocular lens (IOL) suture fixation, 18 and vitreous surgery. 19,20 Although numerous surgical procedures are available, each has its own specific advantages and disadvantages. Two direct procedures are mainly performed for cyclopexy: external and internal approaches.…”

“…Among various surgical interventions, direct cyclopexy has been widely used by many surgeons worldwide. [9][10][11][12][13][14][15][16][17][18][19][20] These interventions include ciliary body suturing (cyclopexy), [12][13][14] cyclocryotherapy, 10,11 laser photocoagulation, 3,15 encircling, 16,17 intraocular lens (IOL) suture fixation, 18 and vitreous surgery. 19,20 Although numerous surgical procedures are available, each has its own specific advantages and disadvantages.…”

“…Wang and Zhao 20 recently reported the effectiveness of vitrectomy with air endotamponade for traumatic cyclodialysis and, based on comparison of vitrectomy and silicone oil endotamponade with/without cyclopexy, suggested that vitrectomy with endotamponade was sufficient to treat cyclodialysis cleft and that cyclopexy was not always necessary.…”