Kluś Adam, Kosatka Mariusz, Kozera Milena, Rękas Marek
Department of Ophthalmology, Military Institute of Medicine, 128 Szaserów St., 04-141, Warsaw, Poland.
J Med Case Rep. 2017 Jan 23;11(1):22. doi: 10.1186/s13256-016-1170-6.
A cyclodialysis cleft is a gap resulting from disruption of the longitudinal fibers constituting the ciliary body attachment to the scleral spur. The cyclodialysis cleft can be of traumatic or iatrogenic origin, and it may occur during intraocular surgery or as a result of a glaucoma operation. In this report we present a surgical technique to treat cyclodialysis: cyclopexy combined with phacoemulsification subluxation lens, transscleral suturing of Cionni ring, and intraocular lens implantation with iris cerclage suture.
A 44-year-old Polish woman experienced a traumatic cyclodialysis cleft in her left eye, complicated by persistent hypotony, maculopathy, lens subluxation, and pupillary sphincter injury. Her corrected distance visual acuity was 0.1 (Snellen chart) and intraocular pressure 3.0 mmHg. We performed direct cyclopexy, anterior vitrectomy, removal of the subluxated lens by phacoemulsification, followed by an insertion of a capsular tension ring with 1-point scleral suture fixation with implantation of intraocular lens in the capsular bag and suturing around the pupil. Anterior segment optical coherence tomography revealed closure of the cleft by reattachment of the ciliary body to the sclera spur. Her corrected distance visual acuity was 0.8 and intraocular pressure 18 mmHg.
The choice of operating technique depends on the area of the ciliary body dialysis, the number of clefts and their location, the presence of other abnormalities of the ocular structures, and the surgical skills of the operator. Cyclopexy combined with phacoemulsification and transscleral suturing of Cionni ring and intraocular lens implantation with iris cerclage suture can be a good solution in cases of this type. The applied surgical technique proved to be effective.
睫状体分离间隙是由于构成睫状体附着于巩膜突的纵向纤维中断而形成的间隙。睫状体分离间隙可由外伤或医源性因素引起，可能发生于眼内手术期间或青光眼手术之后。在本报告中，我们介绍一种治疗睫状体分离的手术技术：睫状体固定术联合超声乳化晶状体半脱位、Cionni环经巩膜缝合以及虹膜环扎缝线的人工晶状体植入术。
一名44岁的波兰女性左眼发生外伤性睫状体分离间隙，并发持续性低眼压、黄斑病变、晶状体半脱位和瞳孔括约肌损伤。她的矫正远视力为0.1（Snellen视力表），眼压为3.0 mmHg。我们进行了直接睫状体固定术、前部玻璃体切除术，通过超声乳化摘除半脱位的晶状体，随后植入囊袋张力环并采用一点巩膜缝线固定，在囊袋内植入人工晶状体并在瞳孔周围缝合。眼前节光学相干断层扫描显示睫状体重新附着于巩膜突，间隙闭合。她的矫正远视力为0.8，眼压为18 mmHg。
手术技术的选择取决于睫状体分离的范围、间隙的数量及其位置、眼结构的其他异常情况以及手术医生的技能。睫状体固定术联合超声乳化、Cionni环经巩膜缝合以及虹膜环扎缝线的人工晶状体植入术对于此类病例可能是一种良好的解决方案。所应用的手术技术被证明是有效的。
