[Direct cyclopexy in cyclodialysis with persistent hypotony syndrome]

We report the results of direct cyclopexy performed on all 16 eyes of 16 patients between 1980 and 1988. The follow-up was 7 months to 95 months (mean 51.4 months). All eyes had developed persistent ocular hypotony following traumatic (15 eyes) or surgical (1 eye) cyclodialysis. The cyclodialyses extended from 45 degrees-255 degrees (mean 120 degrees). Preoperative intraocular pressure was 0 to 8 mm Hg (mean 2.9 mm Hg); preoperative visual acuity ranged from light perception to 20/50. Direct cyclopexy by suture of the insertion of the ciliary muscle to the scleral spur with 10/0 nylon was performed in 16 eyes according to the technique described earlier. In addition, 7 eyes simultaneously underwent the following operative procedures: tectonic keratoplasty (2 eyes), intracapsular cataract extraction and anterior vitrectomy (3 eyes), extracapsular cataract extraction and implantation of a posterior chamber lens (1 eye), and encircling procedure (1 eye). During and after cyclopexy no severe complications were observed. During the immediate postoperative course four eyes developed temporary increased intraocular pressure (26 to 50 mm Hg), which was controlled by medication and was fully reversible. After cyclopexy the cyclodialysis cleft was closed in 15 of 16 eyes with a small persisting cleft (30 degrees) without ocular hypotony persisting in one eye. No new anterior synechiae developed. Visual acuity improved in 14 of 16 eyes (20/80 to 20/20) being 20/40 or better in 10 eyes. In only two eyes was there no improvement in visual acuity as a result of severe traumatic posterior changes. During further postoperative follow-up, the intraocular pressure was below 20 mm Hg in all eyes.(ABSTRACT TRUNCATED AT 250 WORDS)