J Korean Ophthalmol Soc.  2015 Feb;56(2):300-303. 10.3341/jkos.2015.56.2.300.

A Case of Cyclodialysis Cleft with Hypotony during Ahmed Valve Implantation Surgery

• Kim HY
• Kim JW

• KMID: 2216018
• DOI: http://doi.org/10.3341/jkos.2015.56.2.300

Abstract

PURPOSE
To report a case of cyclodialysis cleft with hypotony during Ahmed valve implantation.
CASE SUMMARY
A 47-year-old male was referred for uncontrolled intraocular pressure (IOP) in the right eye. The patient had a history of ocular trauma and traumatic hyphema. He underwent pars plana vitrectomy, phacoemulsification and intraocular lens implantation 1 month prior due to rhegmatogenous retinal detachment. At the end of the Ahmed valve implantation surgery, the eye was hypotonic despite a deep anterior chamber. The hypotony continued and choroidal effusion developed. Anterior segment optical coherence tomography and gonioscopic examinations revealed small cyclodialysis clefts. After medical treatment with cycloplegics and steroids, choroidal effusion disappeared and IOP was normalized.
CONCLUSIONS
Patients with previous ocular trauma or surgery could be prone to developing cyclodialysis cleft with hypotony. Inadvertent cyclodialysis cleft with hypotony can be treated with cycloplegics and steroids.

Keyword

Cyclodialysis cleft; Cycloplegics; Glaucoma; Hypotony; Steroid

MeSH Terms

Anterior Chamber
Choroid
Glaucoma
Humans
Hyphema
Intraocular Pressure
Lens Implantation, Intraocular
Male
Middle Aged
Mydriatics
Phacoemulsification
Retinal Detachment
Steroids
Tomography, Optical Coherence
Vitrectomy
Mydriatics
Steroids

Figure

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  Figure 1. B-scan ultrasonography reveals shallow choroidal detachment (A) and effusion (B).

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  Figure 2. Anterior segment OCT reveals cyclodialysis cleft (left). OCT = optical coherence tomography.

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  Figure 3. Gonioscopy reveals suspected small cyclodialysis at the corresponding region of anterior segment OCT. OCT = optical coherence tomography.

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  Figure 4. Choroidal detachment disappeared after medical treatment for 2 weeks.

Reference

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