Surgical management of ocular hypotony

Over the last 5 years, at the Eye Department in Bremen, 13 eyes with persistent hypotony have been treated by a refixation of the detached ciliary body, the so-called 'direct cyclopexy'. Ten eyes became hypotonous because of a traumatic cyclodialysis and 3 eyes as a result of an antiglaucomatous cyclodialysis surgery. The duration of the hypotony was from 10 days to 3 months, and the various cyclodialyses extended from 30 to 120 degrees. The postoperative follow-up was from 6 months to 5 years. The intraocular pressure was stabilised in all 10 eyes with traumatic cyclodialysis. In the 3 eyes with postoperative cyclodialysis all needed further antiglaucomatous procedures because of high intraocular pressure. In all 13 eyes the typical signs of hypotony disappeared postoperatively and visual improvement was achieved. The surgical procedure is discussed.