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Abstract
Purpose
To report a case of a cyclodialysis cleft that was successfully managed with gonioscopically guided transscleral cyclopexy using partial-thickness scleral flap.
Case summary
A 44-year-old man complaining of blurred vision in the left eye after blunt trauma was referred to our hospital. The intraocular pressure (IOP) was 4 mmHg and the visual acuity was counting finger. Gonioscopy examination revealed cyclodialysis cleft from 3 to 6 o'clock and fundus examination revealed macular folds. After the failure of conservative medical therapy and laser photocoagulation, gonioscopically guided transscleral cyclopexy using partial-thickness scleral flap was performed. Four months later, the IOP was 18 mmHg, the visual acuity was 0.8, and fundus examination showed the disappearance of the macular folds.
Figures and Tables
Figure 1
Preoperative fundus photography and optical coherence tomography. (A) Fundus photograph showing chorioretinal folds at macular area. (B) Optical coherence tomography showing wrinkling of the retina and the choroid.
Figure 2
Surgical procedures of transscleral cyclopexy using partial-thickness scleral flap. (A) A partial thickness scleral flap was created at the site of the cleft. (B) Cyclodialysis cleft was observed using Zeiss 4-mirror (Carl Zeis Meditec AG) gonioprism. (C) Cleft was closed with 10-0 nylon suture passing through the sclera and the detached ciliary body. (D) The cleft was closed completely with interrupted 10-0 nylon sutures.
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