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Case Reports
. 2021 Jan 21;12(1):83-91.
doi: 10.1159/000510756. eCollection 2021 Jan-Apr.

A Case of Cyclodialysis after Microhook Trabeculotomy Treated with Vitreous Surgery

Takashi Kudo  1 , Yukihiko Suzuki  1 , Kodai Yamauchi  1 , Toshio Tando  1 , Kobu Adachi  1 , Mitsuru Nakazawa  1
Affiliations
Case Reports

A Case of Cyclodialysis after Microhook Trabeculotomy Treated with Vitreous Surgery

Takashi Kudo et al. Case Rep Ophthalmol. .

Abstract

We report a case of cyclodialysis with decreased visual acuity after microhook trabeculotomy (mTLO) successfully treated by vitreous surgery. A 41-year-old man had been medically treated for primary open-angle glaucoma in both eyes. He was scheduled to undergo mTLO due to progression of visual field impairment and unstable intraocular pressure in his right eye. His preoperative best-corrected visual acuity (BCVA) was 0.4 OD, and the intraocular pressure was unstable, ranging from 12 to 27 mm Hg. On the day after the operation, a shallow anterior chamber developed, and a low intraocular pressure occurred. His visual acuity continued to decrease, and cyclodialysis was confirmed by ultrasonic biomicroscopy. No improvement was obtained with medical treatment, and his BCVA dropped to 0.08 OD, while his intraocular pressure remained at 2-3 mm Hg. Three months later, a second surgery was performed by combining cataract surgery with intraocular lens implantation, vitrectomy, cryopexy for the pars plana of the ciliary body, and 20% SF6 gas tamponade. Two weeks after the reoperation, the intraocular pressure had been normalized to 12 mm Hg, and the BCVA had returned to 0.3. We successfully treated cyclodialysis as a complication after mTLO by vitreous surgery that led to the recovery of the visual acuity and intraocular pressure.

Keywords: Cyclodialysis; Hypotony maculopathy; Microhook trabeculotomy; Vitrectomy.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Membrane-like substance of the angle that was incised along with the trabecular meshwork and pulled the iris root.
Fig. 2
Fig. 2
Anterior segment and angle findings after the initial surgery. The evaluation showed a shallow anterior chamber, and cyclodialysis of the nasal angle was observed.
Fig. 3
Fig. 3
Ultrasound biomicroscopic findings after the initial surgery. Circumferential ciliary detachment was confirmed, and continuity from the anterior chamber was confirmed on the nasal side.
Fig. 4
Fig. 4
Surgical findings. a Conjunctival incision of trabeculotomy area. b Phacoemulsification and aspiration. c 25-gauge vitrectomy. d Peripheral vitrectomy with scleral pressure. e, f Cryopexy of pars plana. g Intraocular lens implantation. h Fluid-air exchange. i 20% SF6 gas injection.
Fig. 5
Fig. 5
Anterior segment findings after reoperation. The anterior chamber depth became normalized.
Fig. 6
Fig. 6
Ultrasound biomicroscopic findings after reoperation. The ciliary body detachment had almost disappeared.
See this image and copyright information in PMC

References

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