Diagnosis of traumatic cyclodialysis by ultrasound biomicroscopy.
OBJECTIVE
To evaluate the ability of high-frequency ultrasound biomicroscopy to diagnose traumatic cyclodialyses not evident on clinical examination.


METHODS
Six eyes to six patients with posttraumatic hypotony and/or shallow anterior chamber and suspected cyclodialysis clefts were examined with slit-lamp biomicroscopy, gonioscopy, B-scan ultrasonography, and ultrasound biomicroscopy. Ultrasound biomicroscopy provided high resolution of cross-sectional images of the anterior chamber angle, posterior chamber, and anterior uveal tissue.


RESULTS
Ultrasound biomicroscopy confirmed the disinsertion of the ciliary body from the scleral spur and associated ciliary body detachment in all eyes. Gonioscopy failed to demonstrate a cyclodialysis cleft in five eyes because of hyphema (two eyes) and abnormal iris architecture (related to trauma) precluding visualization of the angle recess (three eyes). Using information from ultrasound biomicroscopy imagining, one patient underwent a ciliary body reattachment procedure and repair of the cyclodialysis cleft.


CONCLUSIONS
Ultrasound biomicroscopy is a noninvasive method that can accurately diagnose the presence of traumatic cyclodialyses and can aid in surgical management. It is particularly useful in the presence of hazy media, hypotony, and/or abnormal anterior segment anatomy.
Gentile
R C
RC
Department of Ophthalmology, New York Eye and Ear Infirmary, New York 10003, USA.
Pavlin
C J
CJ
Liebmann
J M
JM
Easterbrook
M
M
Tello
C
C
Foster
F S
FS
Ritch
R
R
D000293:Adolescent; D000328:Adult; D000867:Anterior Chamber / Q000000981:diagnostic imaging; D002924:Ciliary Body / Q000000981:diagnostic imaging* / Q000293:injuries*; D005131:Eye Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D015807:Eye Injuries, Penetrating / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology; D009915:Orbit / Q000000981:diagnostic imaging / Q000293:injuries*; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000209:etiology