Glaucoma Service, Moorfields Eye Hospital, London, UK.
Curr Opin Ophthalmol. 2010 Mar;21(2):150-4. doi: 10.1097/ICU.0b013e3283366a4d.
To report the most recent developments in the diagnosis and management of cyclodialysis clefts.
Cyclodialysis clefts are rare. The most common reason for presentation is blunt-ocular trauma followed by various iatrogenic interventions. Diagnosis is particularly challenging and various new noninvasive techniques have been described to facilitate this process, such as ultrasound biomicroscopy (UBM) and the anterior segment OCT (AS-OCT). The management of cyclodialysis clefts should be conservative initially followed by a variety of nonsurgical and surgical modalities to achieve closure.
The management of cyclodialysis clefts requires a step-wise approach. Initially, it is of particular importance to identify the full extent and location of the cleft as in some cases more than one cleft may be present requiring a variety of nonsurgical and surgical interventions. Nonincisional interventions include the application of various lasers and cryotherapy in the vicinity of the cleft. The traditional approach of direct cyclopexy has more recently been complemented by recent reports of employing modified external plombage procedures, vitrectomy and gas assisted endotamponade. There are insufficient studies formally evaluating these techniques to be able to assess their safety and efficacy.
报道先天性虹膜缺损的最新诊断和治疗进展。
先天性虹膜缺损罕见。最常见的就诊原因是钝挫伤，其次是各种医源性介入。诊断特别具有挑战性，已经描述了各种新的非侵入性技术来辅助这一过程，如超声生物显微镜（UBM）和前节 OCT（AS-OCT）。先天性虹膜缺损的治疗应保守，然后采用各种非手术和手术方法实现闭合。
先天性虹膜缺损的治疗需要逐步进行。最初，尤其重要的是识别裂隙的全部范围和位置，因为在某些情况下可能存在多个裂隙，需要多种非手术和手术干预。非切口干预包括在裂隙附近应用各种激光和冷冻治疗。传统的直接环扎术方法最近已得到补充，最近有报道称采用改良的外部压陷术、玻璃体切除术和气体辅助内填塞术。目前还没有足够的研究来评估这些技术的安全性和疗效。
