Intraoperative UBM-guided direct cyclopexy for traumatic cyclodialysis cleft: a four-case series.

Purpose: To evaluate the feasibility and effectiveness of intraoperative ultrasonic biomicroscopy (UBM)-guided direct cyclopexy for treating traumatic cyclodialysis clefts.

Methods: Intraoperative UBM-guided direct cyclopexy was performed on a total of four eyes. Prior to the conjunctival incision, UBM evaluation was facilitated with a self-designed eye cup. Scleral flaps were generated according to their respective locations. Before the scleral flaps and conjunctiva were closed, UBM was used to promptly assess the repositioning status.

Results: 1.UBM-guided direct cyclopexies were performed on four male patients (mean age: 39.7 years). In all instances, the cyclodialysis cleft resulted from blunt ocular trauma, with an average time interval between injury and surgical treatment of 29.5 days. 2. A simple cyclodialysis cleft was observed in two patients. One patient had retinal detachment and subluxation of the lens, and one presented with a shallow anterior chamber, iridodialysis, cataract, vitreous hemorrhage, papilledema, and hypotony maculopathy. 3. Prior to surgery, the mean IOP in all four patients was 7 mmHg (range: 6-9 mmHg), which increased to an average of 16.5 mmHg on postsurgical day three (range: 11-22 mmHg). 4. UBM examination confirmed successful closure of the cleft in all patients.

Conclusion: During the procedure, UBM-guided direct cyclopexies can accurately assess cyclodialysis cleft repair without being affected by the optical clarity of the refractive media. Preliminary findings demonstrate the feasibility of this approach.