Cionni-modified capsular tension ring for surgical repair of cyclodialysis after trabeculectomy: a case report

To report a case for repair of cyclodialysis after trabeculectomy with Cionni-modified capsular tension ring.

A 64-year-old man who had undergone trabeculectomy of his left eye 3 months earlier visited our clinic owing to blurred vision. His visual acuity was 20/2000 and the intraocular pressure (IOP) was 6 mmHg. Slit-lamp examination showed a shallow anterior chamber and dense cataract. Ultrasound biomicroscopy revealed 360 ° detachment of the ciliary body and suspected cyclodialysis of the trabeculectomy incision. Choroidal detachment was confirmed by B-scan ultrasonography and optical coherence tomography. Phacoemulsification was performed in which a foldable intraocular lens (IOL) was implanted in the capsular bag and a Cionni-modified capsular tension ring (MCTR) was inserted into the ciliary sulcus. The maximum focal point of the MCTR was rotated to the site of the most severe cyclodialysis and the MCTR was sutured to the sclera through its two eyelets. The patient’s best-corrected visual acuity improved to 30/50 and the IOP increased to 16 mmHg after surgery. Gonioscopy and ultrasound biomicroscopy confirmed closure of the cyclodialysis and resolution of choroidal detachment.

Phacoemjulsification with implantation of an intraocular lens combined with insertion of an MCTR into the ciliary sulcus appears to be a relatively safe, effective, minimally invasive method for repairing cyclodialysis in cataract patients. Although the technique yielded good results and appeared to be safe in one patient, further studies are necessary to validate the findings on more patients and with a long-term follow-up.