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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 12/2018

Open Access 01-12-2018 | Cataract

Cyclodialysis cleft repair and cataract management by phacoemulsification combined with internal tamponade using modified capsular tension ring insertion

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 12/2018

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Abstract

Purpose

To evaluate the surgical outcomes of cyclodialysis cleft repair and cataract management by phacoemulsification combined with internal tamponade using a modified capsular tension ring (MCTR) compared with direct cyclopexy.

Methods

The preoperative and postoperative characteristics of patients with cyclodialysis clefts who underwent surgery via insertion of an MCTR into the ciliary sulcus (MCTR group; 16 patients, 16 eyes) or direct cyclopexy (DC group; 16 patients, 16 eyes) were recorded.

Results

The cyclodialysis extended over 2.6 ± 1.9 clock hours in the MCTR group and 3.5 ± 1.8 clock hours in the DC group (P = 0.094). Postoperatively, the IOP was not significantly different between the MCTR and DC groups (12.9 ± 3.7 mmHg vs. 13.8 ± 6.2 mmHg, P = 0.985); the logarithm of the minimal angle of resolution BCVA was better (0.1 ± 0.2 vs. 1.0 ± 0.9, P < 0.001), and the anterior chamber depth was greater (3.87 ± 0.40 mm vs. 2.59 ± 0.58 mm, P < 0.001) in the MCTR group than in the DC group. Compared with the preoperative parameters, the postoperative BCVA, IOP, and anterior chamber depth values were significantly improved in the MCTR group (P < 0.05), whereas the BCVA showed no significant improvement postoperatively in the DC group (P = 0.174). Logistic regression revealed no significant risk factors for successful IOP control or BCVA improvement.

Conclusion

Phacoemulsification combined with internal tamponade using MCTR insertion into the ciliary sulcus is a safe and minimally invasive method for effectively closing cyclodialysis clefts and managing cataract.
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Literature
1.
go back to reference González-Martín-Moro J, Contreras-Martín I, Muñoz-Negrete FJ, Gómez-Sanz F, Zarallo-Gallardo J (2017) Cyclodialysis: an update. Int Ophthalmol 37:441–457CrossRef González-Martín-Moro J, Contreras-Martín I, Muñoz-Negrete FJ, Gómez-Sanz F, Zarallo-Gallardo J (2017) Cyclodialysis: an update. Int Ophthalmol 37:441–457CrossRef
2.
go back to reference Ormerod LD, Baerveldt G, Sunalp MA, Riekhof FT (1991) Management of the hypotonous cyclodialysis cleft. Ophthalmology 98:1384–1393CrossRef Ormerod LD, Baerveldt G, Sunalp MA, Riekhof FT (1991) Management of the hypotonous cyclodialysis cleft. Ophthalmology 98:1384–1393CrossRef
3.
go back to reference Ioannidis AS, Barton K (2010) Cyclodialysis cleft: causes and repair. Curr Opin Ophthalmol 21:150–154CrossRef Ioannidis AS, Barton K (2010) Cyclodialysis cleft: causes and repair. Curr Opin Ophthalmol 21:150–154CrossRef
4.
go back to reference Küchle M, Naumann GO (1995) Direct cyclopexy for traumatic cyclodialysis with persisting hypotony. Report in 29 consecutive patients. Ophthalmology 102:322–333CrossRef Küchle M, Naumann GO (1995) Direct cyclopexy for traumatic cyclodialysis with persisting hypotony. Report in 29 consecutive patients. Ophthalmology 102:322–333CrossRef
5.
go back to reference Aminlari A, Callahan CE (2004) Medical, laser, and surgical management of inadvertent cyclodialysis cleft with hypotony. Arch Ophthalmol 122:399–404CrossRef Aminlari A, Callahan CE (2004) Medical, laser, and surgical management of inadvertent cyclodialysis cleft with hypotony. Arch Ophthalmol 122:399–404CrossRef
6.
go back to reference Ioannidis AS, Bunce C, Barton K (2014) The evaluation and surgical management of cyclodialysis clefts that have failed to respond to conservative management. Br J Ophthalmol 98:544–549CrossRef Ioannidis AS, Bunce C, Barton K (2014) The evaluation and surgical management of cyclodialysis clefts that have failed to respond to conservative management. Br J Ophthalmol 98:544–549CrossRef
7.
go back to reference Trikha S, Turnbull A, Agrawal S, Amerasinghe N, Kirwan J (2012) Management challenges arising from a traumatic 360 degree cyclodialysis cleft. Clin Ophthalmol 6:257–260CrossRef Trikha S, Turnbull A, Agrawal S, Amerasinghe N, Kirwan J (2012) Management challenges arising from a traumatic 360 degree cyclodialysis cleft. Clin Ophthalmol 6:257–260CrossRef
8.
go back to reference Hwang JM, Ahn K, Kim C, Park KA, Kee C (2008) Ultrasonic biomicroscopic evaluation of cyclodialysis before and after direct cyclopexy. Arch Ophthalmol 126:1222–1225CrossRef Hwang JM, Ahn K, Kim C, Park KA, Kee C (2008) Ultrasonic biomicroscopic evaluation of cyclodialysis before and after direct cyclopexy. Arch Ophthalmol 126:1222–1225CrossRef
9.
go back to reference Mateo-Montoya A, Dreifuss S (2009) Anterior segment optical coherence tomography as a diagnostic tool for cyclodialysis clefts. Arch Ophthalmol 127:109–110CrossRef Mateo-Montoya A, Dreifuss S (2009) Anterior segment optical coherence tomography as a diagnostic tool for cyclodialysis clefts. Arch Ophthalmol 127:109–110CrossRef
10.
go back to reference Johnson SM, Cheng HM, Pineda R, Netland PA (1997) Magnetic resonance imaging of cyclodialysis clefts. Graefes Arch Clin Exp Ophthalmol 235:468–471CrossRef Johnson SM, Cheng HM, Pineda R, Netland PA (1997) Magnetic resonance imaging of cyclodialysis clefts. Graefes Arch Clin Exp Ophthalmol 235:468–471CrossRef
11.
go back to reference Jewelewicz DA, Liebmann JM, Ritch R (1999) The use of scleral transillumination to localized the extent of a cyclodialysis cleft. Ophthalmic Surg Lasers 30:571–574PubMed Jewelewicz DA, Liebmann JM, Ritch R (1999) The use of scleral transillumination to localized the extent of a cyclodialysis cleft. Ophthalmic Surg Lasers 30:571–574PubMed
12.
go back to reference Kumar M, Kesarwani S (2011) Post-traumatic cyclodialysis cleft with hypotonic maculopathy. Clin Exp Optom 94:481–483CrossRef Kumar M, Kesarwani S (2011) Post-traumatic cyclodialysis cleft with hypotonic maculopathy. Clin Exp Optom 94:481–483CrossRef
13.
go back to reference Kahawita S, Cugati S, Casson R (2015) Cyclodialysis cleft with late hypotony maculopathy after inadvertent cannula detachment during cataract surgery. J Cataract Refract Surg 41:1107–1108CrossRef Kahawita S, Cugati S, Casson R (2015) Cyclodialysis cleft with late hypotony maculopathy after inadvertent cannula detachment during cataract surgery. J Cataract Refract Surg 41:1107–1108CrossRef
14.
go back to reference Maumenee AE, Stark WJ (1971) Management of persistent hypotony after planned or inadvertent cyclodialysis. Am J Ophthalmol 71:320–327CrossRef Maumenee AE, Stark WJ (1971) Management of persistent hypotony after planned or inadvertent cyclodialysis. Am J Ophthalmol 71:320–327CrossRef
15.
go back to reference Pinheiro-Costa J, Melo AB, Carneiro ÂM, Falcão-Reis F (2015) Cyclodialysis cleft treatment using a minimally invasive technique. Case Rep Ophthalmol 6:66–70CrossRef Pinheiro-Costa J, Melo AB, Carneiro ÂM, Falcão-Reis F (2015) Cyclodialysis cleft treatment using a minimally invasive technique. Case Rep Ophthalmol 6:66–70CrossRef
16.
go back to reference Agrawal P, Shah P (2013) Long-term outcomes following the surgical repair of traumatic cyclodialysis clefts. Eye (Lond) 27:1347–1352CrossRef Agrawal P, Shah P (2013) Long-term outcomes following the surgical repair of traumatic cyclodialysis clefts. Eye (Lond) 27:1347–1352CrossRef
17.
go back to reference Murta F, Mitne S, Allemann N, Paranhos Junior A (2014) Direct cyclopexy surgery for post-traumatic cyclodialysis with persistent hypotony: ultrasound biomicroscopic evaluation. Arq Bras Oftalmol 77:50–53CrossRef Murta F, Mitne S, Allemann N, Paranhos Junior A (2014) Direct cyclopexy surgery for post-traumatic cyclodialysis with persistent hypotony: ultrasound biomicroscopic evaluation. Arq Bras Oftalmol 77:50–53CrossRef
18.
go back to reference Mandava N, Kahook MY, Mackenzie DL, Olson JL (2006) Anterior scleral buckling procedure for cyclodialysis cleft with chronic hypotony. Ophthalmic Surg Lasers Imaging 37:151–153PubMed Mandava N, Kahook MY, Mackenzie DL, Olson JL (2006) Anterior scleral buckling procedure for cyclodialysis cleft with chronic hypotony. Ophthalmic Surg Lasers Imaging 37:151–153PubMed
19.
go back to reference Gupta S, Sagar P, Gogia V, Khokhar S, Dada T (2016) Dual endotemponade for extensive long-standing cyclodialysis using sulcus-fixated Cionni ring and PCIOL. J Glaucoma 25:e284–e287CrossRef Gupta S, Sagar P, Gogia V, Khokhar S, Dada T (2016) Dual endotemponade for extensive long-standing cyclodialysis using sulcus-fixated Cionni ring and PCIOL. J Glaucoma 25:e284–e287CrossRef
20.
go back to reference Chadha N, Lamba T, Belyea DA, Merchant KY (2014) Indirect cyclopexy for treatment of a chronic traumatic cyclodialysis cleft with hypotony. Clin Ophthalmol 8:591–594CrossRef Chadha N, Lamba T, Belyea DA, Merchant KY (2014) Indirect cyclopexy for treatment of a chronic traumatic cyclodialysis cleft with hypotony. Clin Ophthalmol 8:591–594CrossRef
21.
go back to reference Wang C, Peng X, You Q et al (2017) Internal cyclopexy for complicated traumatic cyclodialysis cleft. Acta Ophthalmol 95:639–642CrossRef Wang C, Peng X, You Q et al (2017) Internal cyclopexy for complicated traumatic cyclodialysis cleft. Acta Ophthalmol 95:639–642CrossRef
22.
go back to reference Tang J, Du E, Wang J (2017) Novel surgical management of cyclodialysis cleft via anterior chamber perfusion. Medicine (Baltimore) 96:e7559CrossRef Tang J, Du E, Wang J (2017) Novel surgical management of cyclodialysis cleft via anterior chamber perfusion. Medicine (Baltimore) 96:e7559CrossRef
23.
go back to reference Kluś A, Kosatka M, Kozera M, Rękas M (2017) Surgical reconstruction of traumatic ciliary body dialysis: a case report. J Med Case Rep 11:22CrossRef Kluś A, Kosatka M, Kozera M, Rękas M (2017) Surgical reconstruction of traumatic ciliary body dialysis: a case report. J Med Case Rep 11:22CrossRef
24.
go back to reference Yuen NS, Hui SP, Woo DC (2006) New method of surgical repair for 360-degree cyclodialysis. J Cataract Refract Surg 32:13–17CrossRef Yuen NS, Hui SP, Woo DC (2006) New method of surgical repair for 360-degree cyclodialysis. J Cataract Refract Surg 32:13–17CrossRef
25.
go back to reference Mardelli PG (2006) Closure of persistent cyclodialysis cleft using the haptics of the intraocular lens. Am J Ophthalmol 142:676–678CrossRef Mardelli PG (2006) Closure of persistent cyclodialysis cleft using the haptics of the intraocular lens. Am J Ophthalmol 142:676–678CrossRef
26.
go back to reference Jing Q, Chen J, Chen J, Tang Y, Lu Y, Jiang Y (2017) Cionni-modified capsular tension ring for surgical repair of cyclodialysis after trabeculectomy: a case report. BMC Ophthalmol 17:196CrossRef Jing Q, Chen J, Chen J, Tang Y, Lu Y, Jiang Y (2017) Cionni-modified capsular tension ring for surgical repair of cyclodialysis after trabeculectomy: a case report. BMC Ophthalmol 17:196CrossRef
27.
go back to reference Han JC, Kwun YK, Cho SH, Kee C (2015) Long-term outcomes of argon laser photocoagulation in small size cyclodialysis cleft. BMC Ophthalmol 15:123CrossRef Han JC, Kwun YK, Cho SH, Kee C (2015) Long-term outcomes of argon laser photocoagulation in small size cyclodialysis cleft. BMC Ophthalmol 15:123CrossRef
28.
go back to reference Shentu X, Zhu Y, Tang Y (2011) Closure of a persistent cyclodialysis cleft using the haptics of a normal-sized intraocular lens. BMJ Case Rep 2011 Shentu X, Zhu Y, Tang Y (2011) Closure of a persistent cyclodialysis cleft using the haptics of a normal-sized intraocular lens. BMJ Case Rep 2011
29.
go back to reference Malandrini A, Balestrazzi A, Martone G, Tosi GM, Caporossi A (2008) Diagnosis and management of traumatic cyclodialysis cleft. J Cataract Refract Surg 34:1213–1216CrossRef Malandrini A, Balestrazzi A, Martone G, Tosi GM, Caporossi A (2008) Diagnosis and management of traumatic cyclodialysis cleft. J Cataract Refract Surg 34:1213–1216CrossRef
30.
go back to reference Davis RM, Campbell DM, Jacoby BG (1991) Ciliary sulcus anatomical dimensions. Cornea 10:244–248CrossRef Davis RM, Campbell DM, Jacoby BG (1991) Ciliary sulcus anatomical dimensions. Cornea 10:244–248CrossRef
Metadata
Title
Cyclodialysis cleft repair and cataract management by phacoemulsification combined with internal tamponade using modified capsular tension ring insertion
Publication date
01-12-2018
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 12/2018
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-018-4149-8

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