gms | German Medical Science

Cyclodialysis is a rare complication following blunt traumatic bulb injuries or surgical interventions. Provided that treatment with cycloplegics or steroids is ineffective in attaching the ciliary body, cyclodialysis should be surgically treated. However, for reliable diagnosis and surgical therapy an exact identification (greatness and largeness) of the cyclodialysis cleft is imperative. Ultrasound biomicroscopy (UBM) provides the suitable equipment.

Four patients (19 to 65 years old, mean 45 years) with detached ciliary body are reported. Three patients had suffered an injury, and one patient presented a preceded trabeculotomy. The diagnosis was established with UBM. The space of the cyclodialysis cleft ranged between 2 and 3 hours (mean 2.4 hours).

In spite of an intensive treatment with cycloplegics and steroids no reattachment of the cyclodialysis took place. Therefore, a surgical intervention was performed. The span between the injury and trabeculotomy, respectively, and the cyclodialysis operation ranged from 3 to 30 months (means 12 months). On an average, visual acuity was increased from 0.3 preoperatively to 0,6 postoperatively, and the intraocular pressure was 6 mm Hg before and 15 mm Hg after operation. Symptoms preoperatively found without exception (choroidal detachment, papilledema "e vacuo", macular edema), had a complete recovery after operation.

Provided that drug therapies are unsuccessful in attaching the ciliary body, an operative fixation ist recommendable. UBM is a very useful tool for making an exact diagnosis and location of cyclodialysis as well as a prosperous surgical treatment.