Modified technique for reconstruction of large cyclodialysis cleft with capsular tension ring and continuous and cerclage sutures without scleral flaps.

To present a modified technique for the reconstruction of a large cyclodialysis cleft with capsular tension ring (CTR) and continuous and cerclage sutures without scleral flaps in 12 cases. The mean visual acuity was 0.75 ± 0.47 logarithm of the minimal angle of resolution (logMAR), and the average intraocular pressure (IOP) was 3.35 ± 0.41 mmHg before surgery. Ultrasound biomicroscopy (UBM) revealed a ciliary cleft of 4.3 ± 3.5 clock hours. We performed the modified technique for the reconstruction of a large cyclodialysis cleft. Postoperative visual acuity improved to 0.48 ± 0.26 logMAR, and the IOP improved to 15.88 ± 3.81 mmHg. Postoperative UBM showed that cyclodialysis disappeared in the whole circumference of 12 eyes. The postoperative complications included 42% (5 eyes) with a temporary elevation of IOP and 16% (2 eyes) with a posterior shift of the ciliary body. No other complications were detected during the follow-up. Based on the results, our modified technique might be useful for most cyclodialysis clefts.

The risk of glaucoma associated with phacomatosis cesioflammea and phacomatosis cesioflammeo-marmorata

Background: The ocular features of phacomatosis pigmentovascularis (PPV) have rarely been reported, and glaucoma is the leading cause of blindness in patients with this condition. To protect vision in these patients, it is important to identify glaucoma as early as possible. Objectives: To systematically report the systemic and ocular manifestations of phacomatosis cesioflammea and phacomatosis cesioflammeo-marmorata, and to investigate a glaucoma risk scoring system. Materials & Methods: In this prospective study, patients with PPV from 2014 to 2021 were included. Clinical information was collected, and associations with glaucoma were evaluated. The suitability of the scoring system was assessed. A systematic literature review and analysis of reported cases of PPV was performed. Results: A total of 28 participants with PPV were included. Their ocular findings were similar, ranging from episcleral hyperpigmentation (78.5%), glaucoma (75%), choroid haemangioma (38%), and retinal vascular abnormalities (48%), to hyperpigmentation of the cornea, iris, lens and fundus. Glaucoma was associated with multiple factors, especially a thick choroid (odds ratio: 2.61; p = 0.008) and a diffuse mass-type of episcleral hyperpigmentation (odds ratio: 41.3; p = 0.027). The risk scoring system was characterized by high sensitivity (84%) and specificity (80%; AUC = 0.91) in predicting glaucoma. Conclusion: In addition to involving the systemic system, phacomatosis cesioflammea and phacomatosis cesioflammeo-marmorata also represent a specific spectrum of ophthalmic vascular malformations and hyperpigmentation. Early and periodic detailed ocular examination are recommended. The novel scoring system will help to tailor follow-up for visual protection.

Ocular Biometry in Primary Angle-Closure Glaucoma Associated with Retinitis Pigmentosa.

BACKGROUND: Retinitis pigmentosa (RP) comprises a group of inherited disorders in which patients typically lose night vision in adolescence and then lose peripheral vision in young adulthood before eventually losing central vision later in life. A retrospective case-control study was performed to evaluate differences in ocular biometric parameters in primary angle-closure glaucoma (PACG) patients with and without concomitant RP to determine whether a relationship exists between PACG and RP. METHODS: We used ultrasound biomicroscopy (UBM) to measure anterior chamber depth (ACD). A-scan biometry was carried out to measure lens thickness (LT) and axial length (AL). Propensity score matching and mixed linear regression model analysis were conducted. 23 patients with chronic primary angle-closure glaucoma (CPACG) associated with RP, 21 patients with acute primary angle-closure glaucoma (APACG) associated with RP, 270 patients with CPACG, and 269 patients with APACG were recruited for this study. RESULTS: There were no significant differences on ACDs, ALs, and relative lens position (RLP) (P > 0.05) between patients with PACG associated with RP and patients with PACG; however, patients with APACG associated with RP had a significantly greater LT than patients with APACG (P < 0.05). CONCLUSION: Patients with PACG associated with RP had the same biometric parameter characteristic as the patients with CPACG and APACG. This may suggest that RP is a coincidental relationship with angle-closure glaucoma.