Concerning Cyclodialysis and Hypotony

Abstract

Since 1905, when Heine described his<i>neue glaucomoperation</i>,¹⁴cyclodialysis, this unique procedure has excited continuing interest. After a discussion concerning cyclodialysis and 1 of its complications, hypotony, we shall report on a case of long-standing postoperative hypotony (6 years) and the noteworthy result of therapy. The mode of action of cyclodialysis has been diligently sought. It was Heine's contention that his operation created a pathway through which aqueous could reach the suprachoroidal space, where it would be absorbed. Elschnig¹⁰and then Barkan³histologically demonstrated the presence of this surgically created pathway or cleft in the successfully cyclodialyzed eye. Some investigators^16,19believe that cyclodialysis promotes the escape of aqueous through the usual exit channels either by facilitating access to, or egress from, the canal of Schlemm. By photographing the aqueous veins before and after transcorneal cyclodialysis, an admittedly crude technique, Saeteren and Thomassen²⁰concluded that aqueous