Ocular hypotony associated with a cyclodialysis cleft presents a challenging clinical problem for which several therapeutic solutions have been suggested. We report a case of postsurgical hypotony associated with cyclodialysis clefts that responded to intravitreous gas tamponade and cyclocryopexy.
Report of a Case.
A 73-year-old woman had undergone phacoemulsification with capsular rupture, anterior vitrectomy, and anterior chamber intraocular lens implantation in her right eye. Her visual acuity was 20/200 early postoperatively and did not improve. After several months, the intraocular pressure (IOP) was 10mm Hg but subsequently dropped to 4 mm Hg. Examination revealed mild corneal decompensation associated with superior dehiscence of Descemet's membrane, vitreous prolapse through the pupil and incarceration in the limbal wound, hypotonous maculopathy, and mild cystoid macular edema. There was no evidence of a filtering bleb, and Seidel testing showed no leakage at the area of the wound. Gonioscopy demonstrated two 1—clockhour cyclodialysis clefts in the
Kalenak JW, Pulido JS. Pneumatic Cyclopexy. Arch Ophthalmol. 1995;113(5):558. doi:10.1001/archopht.1995.01100050020014