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Endocyclotamponade with pars plana vitrectomy for management of post-traumatic tractional cyclodialysis cleft
  1. Somya Kumari,
  2. Aayush Majumdar,
  3. Ragib Khan and
  4. Shikha Gupta
  1. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Shikha Gupta; dr.shikhagupta84{at}gmail.com

Abstract

A female in her 20s presented with a diminution of vision in the right eye (RE) following an open globe injury (scleral penetration) and repair a year back. At the presentation, she had low intraocular pressure (IOP) of 7 mm Hg, posterior subcapsular cataract (PSC), retrolental vitreous bands incarcerated at the penetration site, disc oedema, tortuous vessels and choroidal folds. Inferotemporal and superonasal cyclodialysis clefts were detected on CASIA 2 optical coherence tomography (OCT). The diagnosis of RE repaired scleral penetration, PSC and cyclodialysis cleft with hypotony maculopathy was made. The case was managed by phacoemulsification with an intraocular lens in the bag and a capsular tension ring in the sulcus, as a tamponading agent to close the cleft. Intraoperatively on endoscopic visualisation, vitreous membrane was noticed encasing the ciliary processes causing a tractional cyclodialysis and hence single port 23G pars plana vitrectomy was performed to relieve the traction. Postsurgery, IOP was 14 mm Hg, and the repaired cleft was visualised on anterior segment OCT.

  • Eye
  • Anterior chamber

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: SK, AM, RK, SG. The following author gave final approval of the manuscript: SG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.