Clinical Features and Histopathological Findings of Traumatic Cyclodialysis Clefts

ABSTRACT

PURPOSE: Cyclodialysis clefts occur when the meridional ciliary muscle fibers become separated from the scleral spur, thereby providing a new drainage pathway of aqueous humor into the suprachoroidal space. Although the mechanism by which cyclodialysis lowers IOP is both of the hyposecretion of aqueous humor and the increased uveoscleral outflow, cyclodialysis clefts do not always cause hypotony. METHODS: The authors retrospectively analyzed the data of 9 eyes of 9 patients who had been diagnosed as traumatic cyclodialysis cleft by gonioscopic examination. RESULTS: Only 4 of the 9 eyes showed hypotony. This hypotony occurred 3 to 13 days (mean 7.3 days) after trauma. Conservative treatment combined with air injection was done in 4 patients with hypotony. In 3 eyes, IOP was normalized 7~10 days after the above treatment. The remaining one eye had an extensive cyclodialysis of 6 o clock and was treated with argon laser. But normalization of IOP was not achieved within the follow up period. Only cyclodialysis clefts of relatively small range were closed spontaneously or with only conservative management. Also posterior synechiae was found in one of the four eyes with hypotony, and was found in three of the four eyes without hypotony. CONCLUSION: Whether hypotony in cyclodialysis patients occur or not depends on the individual ability of scar formation in the cyclodialysis cleft against the anti-proliferative properties of aqueous humor.