Thomas A Berk1, Jella A An, Iqbal Ike K Ahmed. 1. *Department of Ophthalmology, McGill University, Montréal, QC ‡Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine, Toronto §Trillium Health Partners, Mississauga ∥Prism Eye Institute, Mississauga, ON, Canada †Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, MO.
Abstract
PURPOSE: To report the first case of inadvertent cyclodialysis cleft and hypotony requiring surgical repair following ab-interno trabeculotomy (AIT) using the Trabectome device, and the postoperative clinical results following direct suture cyclopexy. METHODS: A 55-year-old man with hypotonous maculopathy secondary to cyclodialysis cleft inadvertently created 3 years earlier during AIT using the Trabectome device was referred for repair. Direct suture cyclopexy was performed and topical homatropine and dexamethasone drops were prescribed postoperatively. RESULTS: Gonioscopic examination revealed complete cleft closure on postoperative day 1 confirmed by anterior segment optical coherence tomography. At 11 weeks postoperatively, visual acuity had improved from 20/400 to 20/40, with resolution of preoperative macular folds on fundoscopic examination. At 9 months postoperatively, visual acuity had further improved to 20/20 with intraocular pressure stable at 9 mm Hg maintained on travoprost and brimonidine. CONCLUSIONS: Inadvertent cyclodialysis cleft from a malpositioned AIT and resultant hypotony is rare and in this case was successfully treated by direct suture cyclopexy.
PURPOSE: To report the first case of inadvertent cyclodialysis cleft and hypotony requiring surgical repair following ab-interno trabeculotomy (AIT) using the Trabectome device, and the postoperative clinical results following direct suture cyclopexy. METHODS: A 55-year-old man with hypotonous maculopathy secondary to cyclodialysis cleft inadvertently created 3 years earlier during AIT using the Trabectome device was referred for repair. Direct suture cyclopexy was performed and topical homatropine and dexamethasone drops were prescribed postoperatively. RESULTS: Gonioscopic examination revealed complete cleft closure on postoperative day 1 confirmed by anterior segment optical coherence tomography. At 11 weeks postoperatively, visual acuity had improved from 20/400 to 20/40, with resolution of preoperative macular folds on fundoscopic examination. At 9 months postoperatively, visual acuity had further improved to 20/20 with intraocular pressure stable at 9 mm Hg maintained on travoprost and brimonidine. CONCLUSIONS:Inadvertent cyclodialysis cleft from a malpositioned AIT and resultant hypotony is rare and in this case was successfully treated by direct suture cyclopexy.
Authors: Daniela Alvarez-Ascencio; Jesus Jimenez-Roman; Rafael Castañeda-Diez; Gabriel Lazcano-Gomez Journal: Int J Ophthalmol Date: 2019-10-18 Impact factor: 1.779
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