J Korean Ophthalmol Soc.  2012 Nov;53(11):1689-1693.

Cyclocryotherapy and Intravitreal Gas Tamponade of a Chronic Cyclodialysis Cleft: Case Report

• Kim SJ
• Huh HD
• Park JM
• Yoo JM
• Seo SW

Abstract

PURPOSE
To report a case of chronic hypotony maculopathy caused by traumatic cyclodialysis cleft and treated with 20% sulfur hexafluoride (SF6) gas tamponade with cyclocryotherapy.
CASE SUMMARY
A 39-year-old woman with a history of blunt trauma developed a unilateral chronic ocular hypotony in her left eye. She was treated with topical atropine sulphate 1% for 2 months. Three years later, she was referred to our clinic for evaluation and treatment of persistent hypotony. The intraocular pressure (IOP) was 4 mm Hg and the best corrected visual acuity was 0.4. B-scan echography revealed a choroidal effusion and fundus examination showed choroidal detachment and macular folds. Gonioscopy examination revealed cyclodialysis cleft from the direction of 7 o'clock to 11 o'clock. A single bubble of SF6 20% (0.4 cc) was injected into the vitreous cavity and transconjunctival cyclocryotherapy was performed under retrobulbar anesthesia. Six months later, the IOP was 12 mm Hg and the best corrected visual acuity was 1.0. B-scan echograpy and fundus examination showed the disappearance of the choroidal effusion.
CONCLUSIONS
Gas tamponade with cyclocryotherapy may be useful in cases of cyclodialysis cleft that failed to respond to medical therapy.

Keyword

Cyclocryotherapy; Cyclodialysis cleft; Hypotony maculopathy; Sulfur hexafluoride

MeSH Terms

Adult
Anesthesia
Atropine
Choroid
Eye
Female
Gonioscopy
Humans
Intraocular Pressure
Ocular Hypotension
Sulfur Hexafluoride
Visual Acuity
Atropine
Sulfur Hexafluoride

Figure

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  Figure 1 Preoperative examination. (A) Gonioscopy examination revealed cyclodialysis cleft from 7 o'clock to 11 o'clock. (B) Pentacam showed anterior displacement of lens-iris diaphragm and shallow anterior chamber. (C, D) Fundus photograph and B-scan echography revealed a choroidal detachment and macular folds and choroidal effusion. (E) The preoperative optical coherence tomography showed macular edema with chorioretinal folds.

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  Figure 2 The examinations 6 months after operation. (A) Gonioscopy examination displayed the closure of the cyclodialysis cleft. (B) Pentacam showed the deepening of anterior chamber. (C) Fundus photograph showed disappearance of chorioretinal folds. (D) B-scan echography revealed a loss of choroidal detachment. (E) The postoperative optical coherence tomography showed marked resolution of the chorioretinal folds and serous fluid.

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