1c:I[419806,["/_next/static/chunks/bb923814e1f4d2e9.js","/_next/static/chunks/dd3ee9f5b7716ca6.js","/_next/static/chunks/4204a0ae82542ca8.js","/_next/static/chunks/30036bedc5269936.js","/_next/static/chunks/6e1aa89a642f40be.js","/_next/static/chunks/cd5e572bc3e4eb92.js","/_next/static/chunks/8ffd0b71567920d8.js","/_next/static/chunks/67ea6dfd21f16c5f.js","/_next/static/chunks/24eb4379f68013fd.js","/_next/static/chunks/b8cd775ffdf935bd.js","/_next/static/chunks/983103cd9eb7b428.js","/_next/static/chunks/d4ac9dcf27f6ff52.js","/_next/static/chunks/294b9525248c8e5f.js"],"default"] 1d:T447,Since 1905, when Heine described hisneue glaucomoperation,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 aqueous1e:T46a,A 48-year-old man presented with hyphema, iridocyclitis, iridophacodonesis, and maculopathy after a contusive trauma. Ultrasound biomicroscopy identified a 90-degree cyclodialysis cleft with severe damage of the zonular fibers. Echographic B-scan examination revealed intravitreal hemorrhage and a 360-degree choroidal detachment. One month later, phacoemulsification was performed and a single-piece poly(methyl methacrylate) intraocular lens was inserted into the ciliary sulcus, with the haptic rotated toward the cyclodialysis cleft area. Postoperatively, the visual acuity improved and the intraocular pressure returned to normal. Ultrasound biomicroscopy showed closure of the cleft by reattachment of the ciliary body to the scleral spur. Optical coherence tomography revealed complete resolution of the macular and choroidal folds. Ultrasound biomicroscopy is a useful method for appropriate management of traumatic cyclodialysis cleft. In cases of small cyclodialysis clefts, with the surgical method we describe, the lens haptics apply directional force toward the sclera, fostering adherence of the ciliary body fibers.

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