J Korean Ophthalmol Soc.  2017 Feb;58(2):240-243. 10.3341/jkos.2017.58.2.240.

Novel Adjuvant Method to Assist Localisation of a Cyclodialysis Cleft

• Baek J
• Choi KJ
• Lee KW
• Kwon S

• KMID: 2369477
• DOI: http://doi.org/10.3341/jkos.2017.58.2.240

Abstract

PURPOSE
To introduce a novel adjuvant technique to locate cyclodialysis cleft using a laser pointer in a gonioscopic view.
CASE SUMMARY
A 36-year-old man complaining of blurred vision in his left eye after blunt trauma 2 weeks prior was referred to our hospital. Gonioscopy showed a cyclodialysis cleft from 3 to 4 o'clock and fundus revealed hypotonic maculopathy. After the failure of medical treatment, we tried various interventions such as injection of viscoelastic agent into the anterior chamber and intravitreal gas tamponade with transconjunctival cryotherapy. Since those were not successful, we decided to treat the patient with direct cyclopexy. For the preoperative localization of the cleft, we tried a new technique that uses a laser pointer. On gonioscopic examination, an assistant shot the laser toward the limbal area where the suspicious cleft was located. We were able to precisely locate the cyclodialysis cleft if the laser pointer light was seen through the cleft in the gonioscopic view. With the aid of a laser a pointer, the cleft was successfully closed.
CONCLUSIONS
Localization with a laser pointer is simple, safe, rapid, and helpful for planning surgical repair of a cyclodialysis cleft without expensive equipment.

Keyword

Cyclodialysis cleft; Hypotonic maculopathy; Localization of cyclodialysis cleft; Traumatic hypotony

MeSH Terms

Adult
Anterior Chamber
Cryotherapy
Gonioscopy
Humans
Methods*

Figure

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  Figure 1. Localization of the cyclodialysis cleft with the laser pointer, during gonioscopic examination. (A) Laser pointer light in normal gonioscopic view. (B) Macular wrinkling was shown at fundus photography. (C) The novel method with laser pointer was used for cyclodialysis cleft localisation. (D) After direct cyclopexy, the cyclodialysis cleft was closed. (E) The laser pointer that was used to locate of small cyclodialysis clefts.

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  Figure 2. Schematic diagram to illustrate how to localize cy-clodialysis cleft with the laser pointer during gonioscopic examination. During gonioscopic examination, an assistant shot the laser toward the limbal area where the suspicious cleft was located.

Reference

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