Diagnosis and management of iatrogenic trochar-induced cyclodialysis cleft with intraoperative gonioscopy and argon endolaser

Samuel M Dresner; Yasmin Florence Khodeja Islam; Thomas A Lazzarini; Jorge Fortun; Arindel S R Maharaj

doi:10.1016/j.ajoc.2022.101650

Diagnosis and management of iatrogenic trochar-induced cyclodialysis cleft with intraoperative gonioscopy and argon endolaser

Am J Ophthalmol Case Rep. 2022 Jul 1:27:101650. doi: 10.1016/j.ajoc.2022.101650. eCollection 2022 Sep.

Authors

Samuel M Dresner¹, Yasmin Florence Khodeja Islam¹, Thomas A Lazzarini¹, Jorge Fortun¹, Arindel S R Maharaj¹

Affiliation

¹ Bascom Palmer Eye Institute, University of Miami, 7101 Fairway Drive, Palm Beach Gardens, Florida, USA.

Abstract

Purpose: To report a case of iatrogenic vitrectomy trochar-induced cyclodialysis cleft successfully treated with intraoperative argon endolaser.

Observations: A 68-year-old Caucasian male with a history of high myopia underwent pars plana vitrectomy to clear symptomatic vitreous opacities but developed early postoperative hypotony that was recalcitrant to medical management for the first 6 postoperative months. Intraoperative gonioscopy demonstrated a cyclodialysis cleft and argon endolaser was applied to close the cleft.

Conclusions and importance: Endolaser is an effective treatment for cyclodialysis clefts and intraoperative gonioscopy allows direct visualization of the cleft in a controlled operating room setting. Placement of vitrectomy ports should be done with care in high myopes to avoid accidental piercing of the ciliary body and inducing a cyclodialysis cleft.

Keywords: Cleft repair; Cyclodialysis cleft; Endolaser; Iatrogenic complication.

Publication types

Case Reports