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Novel surgical management of cyclodialysis cleft via anterior chamber perfusion: Case report.

Abstract Cyclodialysis cleft is a relatively rare but severe condition with persistent ocular hypotony, which can cause morphologic changes and visual loss. Here we report a case of a traumatic cyclodialysis cleft that was successfully managed with direct cyclopexy via anterior chamber perfusion. During the operation, if there is aqueous humor flowing out of the deep scleral incision, the cleft is not closed, and surgery should continue until there is no aqueous outflow.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28723783
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170808
LR  - 20170808
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 29
DP  - 2017 Jul
TI  - Novel surgical management of cyclodialysis cleft via anterior chamber perfusion: 
      Case report.
PG  - e7559
LID - 10.1097/MD.0000000000007559 [doi]
AB  - RATIONALE: Cyclodialysis cleft is a relatively rare but severe condition with
      persistent ocular hypotony, which can cause morphologic changes and visual loss. 
      Here we report a case of a traumatic cyclodialysis cleft that was successfully
      managed with direct cyclopexy via anterior chamber perfusion. During the
      operation, if there is aqueous humor flowing out of the deep scleral incision,
      the cleft is not closed, and surgery should continue until there is no aqueous
      outflow. PATIENT CONCERNS: A 66-year-old man was treated for severe blunt ocular 
      trauma of the left eye and a resultant cyclodialysis cleft, lens subluxation,
      choroidal detachment and a cataract. His intraocular pressure was 6 mm Hg, he
      presented with a shallow anterior chamber, phacodonesis, iridodonesis, 360
      degrees ciliary body detachment, and a suspicious cyclodialysis cleft in the 5 to
      8 o'clock position. DIAGNOSES:: ocular blunt trauma (left eye), cyclodialysis
      cleft (left eye), lens subluxation (left eye), choroidal detachment (left eye),
      cataract (both eyes). INTERVENTIONS: The cataract was extracted by
      phacoemulsification and a posterior chamber intraocular lens was implanted with 2
      capsular tension rings, one in the lens bag and the other in the ciliary sulcus. 
      Throughout the following month, intraocular pressure fluctuated between 4 and 6
      mm Hg and the ciliary body failed to reattach. A cyclopexy via anterior chamber
      perfusion was thus deemed necessary and performed. OUTCOMES: After cyclopexy,
      intraocular pressure increased to 27 mm Hg and decreased to 16 mm Hg after
      brinzolamide eye drops treatment twice daily for 4 days. Subsequently intraocular
      pressure stabilized between 10 to 21mm Hg. Complete closure of the cyclodialysis 
      cleft was confirmed with ultrasound biomicroscopy. LESSONS: Cyclopexy via
      anterior chamber perfusion for patients with cyclodialysis cleft is a simple,
      safe, and efficient technique that ensures a successful surgery.
FAU - Tang, Jinfei
AU  - Tang J
AD  - Department of Ophthalmology, The First Affiliated Hospital of Zhejiang Chinese
      Medical University, Hangzhou, Zhejiang, China.
FAU - Du, Ergang
AU  - Du E
FAU - Wang, Jie
AU  - Wang J
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Anterior Chamber/diagnostic imaging/drug effects/*surgery
MH  - Cataract/complications/diagnosis/drug therapy
MH  - Cataract Extraction
MH  - Choroid Diseases/diagnosis/drug therapy/etiology/surgery
MH  - Eye Injuries/*complications/diagnosis/drug therapy
MH  - Humans
MH  - Lens Implantation, Intraocular
MH  - Male
MH  - Ocular Hypotension/diagnosis/drug therapy/etiology/*surgery
MH  - Postoperative Complications/diagnostic imaging/drug therapy/surgery
MH  - Wounds, Nonpenetrating/complications/diagnosis/drug therapy
PMC - PMC5521923
EDAT- 2017/07/21 06:00
MHDA- 2017/08/09 06:00
CRDT- 2017/07/21 06:00
AID - 10.1097/MD.0000000000007559 [doi]
AID - 00005792-201707210-00048 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(29):e7559. doi: 10.1097/MD.0000000000007559.