Case report suggests consideration of gas tamponade and cyclocryotherapy for some cyclodialysis clefts

This single-case report describes a novel approach to improving a medically nonresponsive cyclodialysis cleft and hypotony. The authors injected a single bubble of 20% sulfur hexafluoride into the vitreous cavity, followed by transconjunctival cyclocryotherapy. The patient's IOP rose, visual acuity improved and choroidal effusion disappeared. The authors recommended consideration of this treatment for cyclodialysis clefts with shallow anterior chambers that are not responsive to more conservative therapies.

The patient was a 51-year-old with a history of blunt trauma and unilateral chronic hypotony. He had failed three months of treatment with atropine 1%. He had a shallow anterior chamber, IOP of 2 mm Hg and visual acuity of 20/200. The cyclodialysis cleft extended from the 6 to 12 o'clock positions.

After gas absorption two weeks after treatment, IOP improved to 12 mm Hg and visual acuity to 20/50. A small cleft from 8:30 to 9:30 remained, but the distance between the scleral spur and ciliary body decreased and the cleft was limited at the back due to scar formation.