title: Cyclodialysis induced persistent hypotony: surgical management with vitrectomy and endotamponade.
abstract: OBJECTIVE
  To report novel surgical approaches to the management of persistent hypotony after cyclodialysis.
  
  
  METHODS
  Retrospective review of the medical records of six eyes of six patients with persistent hypotony after traumatic cyclodialysis. The diagnosis accuracy of cyclodialysis was documented by ultrasound biomicroscopy in five patients. The other one underwent an anterior segment optical coherence tomography. The authors performed pars plana vitrectomy and silicone oil-assisted endotamponade in four patients. The remaining eyes underwent a gas tamponade after pars plana vitrectomy.
  
  
  RESULTS
  Preoperative visual acuity (Snellen scale) ranged from count fingers to 20/50. The patients' visual acuity improved after the surgery. The intraocular pressure ranged from 2 mmHg to 6 mmHg (mean, 3.33 mmHg) before surgery. The authors did achieve an intraocular pressure normalization postoperatively. After surgery, the ciliary body was completely reattached in all cases. A slight angle recession was documented in one eye.
  
  
  CONCLUSIONS
  The management of cyclodialysis clefts requires a stepwise approach. In cases where conservative management fails, wide ranges of options have been reported. Based on our results, we consider that silicone oil-assisted or gas-assisted endotamponade, after pars plana vitrectomy, can be an effective alternative approach to the cyclodialysis.
authors.affiliation: Instituto de Microcirugia Ocular, Barcelona, Spain. marcodutramedeiros@gmail.com
authors.forename: M Dutra
authors.initials: MD
authors.lastname: Medeiros
authors.forename: Maurizio
authors.initials: M
authors.lastname: Postorino
authors.forename: Carolina
authors.initials: C
authors.lastname: Pallás
authors.forename: Cecilia
authors.initials: C
authors.lastname: Salinas
authors.forename: Carlos
authors.initials: C
authors.lastname: Mateo
authors.forename: J
authors.initials: J
authors.lastname: Garcia-Arumí
authors.forename: Borja
authors.initials: B
authors.lastname: Corcóstegui
mesh_terms: D000328:Adult; D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects; D002924:Ciliary Body / Q000293:injuries*; D058450:Endotamponade; D005131:Eye Injuries / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014949:Wounds, Nonpenetrating / Q000209:etiology*; D055815:Young Adult
chemical_list: D012827:Silicone Oils