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Case Reports
. 2022 Jul 1:27:101650.
doi: 10.1016/j.ajoc.2022.101650. eCollection 2022 Sep.

Diagnosis and management of iatrogenic trochar-induced cyclodialysis cleft with intraoperative gonioscopy and argon endolaser

Samuel M Dresner  1 , Yasmin Florence Khodeja Islam  1 , Thomas A Lazzarini  1 , Jorge Fortun  1 , Arindel S R Maharaj  1
Affiliations
Case Reports

Diagnosis and management of iatrogenic trochar-induced cyclodialysis cleft with intraoperative gonioscopy and argon endolaser

Samuel M Dresner et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: To report a case of iatrogenic vitrectomy trochar-induced cyclodialysis cleft successfully treated with intraoperative argon endolaser.

Observations: A 68-year-old Caucasian male with a history of high myopia underwent pars plana vitrectomy to clear symptomatic vitreous opacities but developed early postoperative hypotony that was recalcitrant to medical management for the first 6 postoperative months. Intraoperative gonioscopy demonstrated a cyclodialysis cleft and argon endolaser was applied to close the cleft.

Conclusions and importance: Endolaser is an effective treatment for cyclodialysis clefts and intraoperative gonioscopy allows direct visualization of the cleft in a controlled operating room setting. Placement of vitrectomy ports should be done with care in high myopes to avoid accidental piercing of the ciliary body and inducing a cyclodialysis cleft.

Keywords: Cleft repair; Cyclodialysis cleft; Endolaser; Iatrogenic complication.

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Conflict of interest statement

The following authors have no financial disclosure: SD, YI, TL, JF, AM.

Figures

Fig. 1
Fig. 1
A. Preoperative macular optical coherence tomography demonstrating hypotonus choroidal folds distorting the fovea despite sub-Tenon's triamcinolone. B. Resolution of choroidal folds three months following endolaser repair of cyclodialysis cleft.
Fig. 2
Fig. 2
A. Intraoperative gonioscopy demonstrating cyclodialysis cleft. B. Argon endolaser applied to cleft using intraoperative gonioscopy.
See this image and copyright information in PMC

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