2020–2021 BCSC Basic and Clinical Science Course™
11 Lens and Cataract
Chapter 10: Intraoperative Challenges in Cataract Surgery
Anterior Segment Complications
Cyclodialysis, the separation of the ciliary body from its insertion at the scleral spur, may occur as a result of trauma or surgical manipulation of intraocular tissue (Fig 10-4). Gonioscopic examination shows a deep-angle recess with a gap between the sclera and the ciliary body (Fig 10-5). Repair of a cyclodialysis cleft is often indicated if hypotony results. Closure may be achieved with laser photocoagulation at the site of cyclodialysis; if this is ineffective, it may be necessary to reattach the ciliary body with sutures (Video 10-5). A significant and sudden elevation in IOP may occur as a result of cyclodialysis closure. For further discussion of cyclodialysis, see BCSC Section 10, Glaucoma.
Closure of a cyclodialysis cleft. Courtesy of Arsham Sheybani, MD.
Figure 10-4 Pathology of cyclodialysis. Detachment of ciliary body muscle (asterisk) from the scleral spur (arrowhead) resulting in a cyclodialysis cleft (arrow).
© 2019 American Academy of Ophthalmology.)
Figure 10-5 Goniophotograph of cyclodialysis. A, Trabecular meshwork. B, Scleral spur. C, Ciliary body band. D, Area of separation of ciliary band from sclera.
(Courtesy of Hans E. Grossniklaus, MD. © 2019 American Academy of Ophthalmology.)
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.