Cyclodialysis cleft repair: A multi-centred, retrospective case series.
ciliary body injuries
cyclodialysis cleft
gonioscopy
intraocular pressure
nonpenetrating trauma
Journal
Clinical & experimental ophthalmology
ISSN: 1442-9071
Titre abrégé: Clin Exp Ophthalmol
Pays: Australia
ID NLM: 100896531
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
16
02
2018
revised:
01
08
2018
accepted:
19
08
2018
pubmed:
24
8
2018
medline:
11
4
2020
entrez:
24
8
2018
Statut:
ppublish
Résumé
There is a paucity of evidence analysing the treatment of cyclodialysis clefts. We describe outcomes following the treatment of this rare condition at six centres internationally. Retrospective case series. Thirty-six patients with a cyclodialysis cleft from 2003 to 2017 were recruited. Clefts were treated with cycloplegic agents, laser therapy and/or surgery. Postoperative best recorded visual acuity (BRVA), intraocular pressure (IOP) and the rate of cleft closure. The mean age was 45 ± 17 years and 29 (80.6%) patients were male. One eye (2.8%) received only medical therapy, 5 (13.9%) received laser, 14 (38.9%) underwent surgery after laser failure and 16 (44.4%) eyes received exclusively surgery. Over 80% of eyes had a BRVA improvement of more than two lines. Closure was attained in 30 eyes (93.8%; n = 32), with postoperative stabilized IOP ≥ 12 mmHg in 29 eyes (80.6%; n = 36) and postoperative BRVA ≤20/50 in 20 eyes (58.8%; n = 34). Improved postoperative BRVA was related to better preoperative BRVA (P = 0.006) and preoperative IOP ≥ 4 mmHg (P = 0.03). There was no significant difference between treatment approach for IOP ≥ 12 mmHg (P = 0.85) or postoperative BRVA ≤20/50 (P = 0.80). Only two eyes at last follow-up required IOP lowering medication. There was a high closure rate with most eyes eventually requiring surgery. Clinically significant improvements in BRVA were found in most eyes. Improved postoperative BRVA was significantly related to better preoperative BRVA and IOP.
Sections du résumé
IMPORTANCE
There is a paucity of evidence analysing the treatment of cyclodialysis clefts.
BACKGROUND
We describe outcomes following the treatment of this rare condition at six centres internationally.
DESIGN
Retrospective case series.
PARTICIPANTS
Thirty-six patients with a cyclodialysis cleft from 2003 to 2017 were recruited.
METHODS
Clefts were treated with cycloplegic agents, laser therapy and/or surgery.
MAIN OUTCOME MEASURES
Postoperative best recorded visual acuity (BRVA), intraocular pressure (IOP) and the rate of cleft closure.
RESULTS
The mean age was 45 ± 17 years and 29 (80.6%) patients were male. One eye (2.8%) received only medical therapy, 5 (13.9%) received laser, 14 (38.9%) underwent surgery after laser failure and 16 (44.4%) eyes received exclusively surgery. Over 80% of eyes had a BRVA improvement of more than two lines. Closure was attained in 30 eyes (93.8%; n = 32), with postoperative stabilized IOP ≥ 12 mmHg in 29 eyes (80.6%; n = 36) and postoperative BRVA ≤20/50 in 20 eyes (58.8%; n = 34). Improved postoperative BRVA was related to better preoperative BRVA (P = 0.006) and preoperative IOP ≥ 4 mmHg (P = 0.03). There was no significant difference between treatment approach for IOP ≥ 12 mmHg (P = 0.85) or postoperative BRVA ≤20/50 (P = 0.80). Only two eyes at last follow-up required IOP lowering medication.
CONCLUSIONS AND RELEVANCE
There was a high closure rate with most eyes eventually requiring surgery. Clinically significant improvements in BRVA were found in most eyes. Improved postoperative BRVA was significantly related to better preoperative BRVA and IOP.
Substances chimiques
Mydriatics
0
Types de publication
Case Reports
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
201-211Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2018 Royal Australian and New Zealand College of Ophthalmologists.