Cyclodialysis cleft: causes and repair

To report the most recent developments in the diagnosis and management of cyclodialysis clefts.

Cyclodialysis clefts are rare. The most common reason for presentation is blunt-ocular trauma followed by various iatrogenic interventions. Diagnosis is particularly challenging and various new noninvasive techniques have been described to facilitate this process, such as ultrasound biomicroscopy (UBM) and the anterior segment OCT (AS-OCT). The management of cyclodialysis clefts should be conservative initially followed by a variety of nonsurgical and surgical modalities to achieve closure.

The management of cyclodialysis clefts requires a step-wise approach. Initially, it is of particular importance to identify the full extent and location of the cleft as in some cases more than one cleft may be present requiring a variety of nonsurgical and surgical interventions. Nonincisional interventions include the application of various lasers and cryotherapy in the vicinity of the cleft. The traditional approach of direct cyclopexy has more recently been complemented by recent reports of employing modified external plombage procedures, vitrectomy and gas assisted endotamponade. There are insufficient studies formally evaluating these techniques to be able to assess their safety and efficacy.