Clinical Manifestations of Cyclodialysis Cleft and Prognostic Factors Associated with Direct Cyclopexy

Ahn, Kyeon; Kee, Changwon

Abstract

PURPOSE
To evaluate the clinical manifestations and the factors associated with prognosis of the traumatic cyclodialysis patients who underwent direct cyclopexy. METHODS: The authors retrospectively analyzed the data of 23 eyes of 22 patients who underwent consecutive direct cyclopexy for the hypotonous cyclodialysis between 1997 and 2002 at the authors' institution. Perioperative A-scan and ultrabiomicroscopy were performed to evalaute correlation between the parameters and postoperative visual prognosis.
RESULTS
Postoperatively, the mean increase of intraocular pressure was 11.1mmHg and the mean improvement of visual acuity was four lines of Han's Korean visual acuity chart. As the preoperative hypotony period was shorter, postoperative visual prognosis was better (p<0.05). Anterior chamber depth (p<0.0001), axial length (p<0.01), spherical equivalent (p<0.05), and intraocular pressure (p<0.0001) were increased, whereas lens thickness (p<0.0001) was decreased postoperatively. Transient postoperative ocular hypertension was controlled by adequate medication, and the patients' intraocular pressure were controlled below 20 mmHg without medications at the average of 19 days after the cyclopexy. Post-operative visual acuity was not significantly correlated with pre-operative intraocular pressure, pre-operative visual acuity, age, or sex. Preoperative extent of cyclodialysis was not significantly correlated with visual prognosis, postoperative development of cataract, intraocular pressure, or the cause of trauma.
CONCLUSIONS
Direct cyclopexy is one of a successful method for the treatment of the hypotonous cyclodialysis cleft, and the early diagnosis and treatment are thought to be necessary for the improvement of visual prognosis.