Cyclodialysis cleft repair and cataract management by phacoemulsification combined with internal tamponade using modified capsular tension ring insertion

Graefes Arch Clin Exp Ophthalmol. 2018 Dec;256(12):2369-2376. doi: 10.1007/s00417-018-4149-8. Epub 2018 Sep 29.

Abstract

Purpose: To evaluate the surgical outcomes of cyclodialysis cleft repair and cataract management by phacoemulsification combined with internal tamponade using a modified capsular tension ring (MCTR) compared with direct cyclopexy.

Methods: The preoperative and postoperative characteristics of patients with cyclodialysis clefts who underwent surgery via insertion of an MCTR into the ciliary sulcus (MCTR group; 16 patients, 16 eyes) or direct cyclopexy (DC group; 16 patients, 16 eyes) were recorded.

Results: The cyclodialysis extended over 2.6 ± 1.9 clock hours in the MCTR group and 3.5 ± 1.8 clock hours in the DC group (P = 0.094). Postoperatively, the IOP was not significantly different between the MCTR and DC groups (12.9 ± 3.7 mmHg vs. 13.8 ± 6.2 mmHg, P = 0.985); the logarithm of the minimal angle of resolution BCVA was better (0.1 ± 0.2 vs. 1.0 ± 0.9, P < 0.001), and the anterior chamber depth was greater (3.87 ± 0.40 mm vs. 2.59 ± 0.58 mm, P < 0.001) in the MCTR group than in the DC group. Compared with the preoperative parameters, the postoperative BCVA, IOP, and anterior chamber depth values were significantly improved in the MCTR group (P < 0.05), whereas the BCVA showed no significant improvement postoperatively in the DC group (P = 0.174). Logistic regression revealed no significant risk factors for successful IOP control or BCVA improvement.

Conclusion: Phacoemulsification combined with internal tamponade using MCTR insertion into the ciliary sulcus is a safe and minimally invasive method for effectively closing cyclodialysis clefts and managing cataract.

Keywords: Cataract; Cyclodialysis cleft; Modified capsular tension ring; Phacoemulsification.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Ciliary Body / surgery*
  • Female
  • Follow-Up Studies
  • Gonioscopy
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Middle Aged
  • Ocular Hypotension / etiology
  • Ocular Hypotension / physiopathology
  • Ocular Hypotension / surgery*
  • Phacoemulsification / adverse effects*
  • Postoperative Complications / surgery*
  • Prospective Studies
  • Prosthesis Implantation