Ultrasonic biomicroscopic evaluation of cyclodialysis before and after direct cyclopexy.
OBJECTIVE
To investigate the clinical manifestations and surgical prognoses after direct cyclopexy in patients with traumatic cyclodialysis according to the cleft extent as determined by ultrasound biomicroscopy (UBM).


METHODS
A detailed ophthalmologic examination, which included gonioscopy and UBM, was performed before and after direct cyclopexy in 32 eyes of 31 patients with traumatic cyclodialysis clefts.


RESULTS
Cyclodialysis clefts were accurately diagnosed and delineated in all 32 eyes using UBM. Cyclodialysis resulted in hypotony with a mean intraocular pressure of 3.2 mm Hg irrespective of cleft size. On A-scan ultrasonography, mean (SD) preoperative and postoperative lens thicknesses were 4.4 (0.4) mm (range, 3.71-4.92 mm) and 4.1 (0.4) mm (range, 3.42-4.57 mm), respectively, and mean (SD) preoperative and postoperative axial lengths were 23.2 (0.7) mm (range, 21.91-24.57 mm) and 23.6 (0.7) mm (range, 22.47-24.56 mm), respectively. The larger a cleft was, the longer it took for a postoperatively elevated intraocular pressure to normalize after direct cyclopexy. Postoperative visual acuities were significantly better than preoperative values, even when direct cyclopexy was performed 54 months after trauma.


CONCLUSIONS
Even small clefts usually resulted in hypotony and visual prognosis was better after cyclopexy, even in cases with a protracted history. Larger clefts need longer postoperative follow-up to check for intraocular pressure normalization after direct cyclopexy.
Hwang
Jeong-Min
JM
Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Ahn
Kyeon
K
Kim
Chihoon
C
Park
Kyung-Ah
KA
Kee
Changwon
C
D000293:Adolescent; D000328:Adult; D002924:Ciliary Body / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery; D003452:Cryosurgery; D005131:Eye Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D015814:Ocular Hypotension / Q000175:diagnosis; D013508:Ophthalmologic Surgical Procedures; D012421:Rupture; D012590:Sclera / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery; D014603:Uveal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D014792:Visual Acuity