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Cyclodialysis Cleft Closure Following Suprachoroidal Spacer Implantation
Jonathan Ji1, Shivani S Kamat2
1University of Texas Southwestern Medical School, University of Texas Southwestern Medical Center, Dallas, TX.
International Ophthalmology Clinics
|June 18, 2026
Summary
Suprachoroidal spacer implantation for glaucoma may lead to cyclodialysis cleft closure, causing severe intraocular pressure spikes. Close monitoring and ultrasound biomicroscopy are crucial for managing this complication.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Ocular Biomechanics
Background:
- A patient with uncontrolled open-angle glaucoma and medication intolerance was considered for novel glaucoma surgery.
- The patient's history of scarring risk and eyelid anatomy precluded traditional incisional glaucoma surgery.
Purpose of the Study:
- To report a case of cyclodialysis cleft closure after ab interno suprachoroidal spacer implantation.
- To highlight the potential for severe intraocular pressure spikes following this procedure.
Main Methods:
- Ab interno cyclodialysis creation and suprachoroidal spacer (AlloFlo) implantation were performed.
- Postoperative intraocular pressure (IOP) and anterior segment were monitored.
- Ultrasound biomicroscopy was used to evaluate the cyclodialysis cleft and surrounding structures.
Main Results:
- Initial IOP reduction was observed postoperatively.
- At 3 weeks, the patient experienced severe IOP elevation (60 mm Hg) despite patent spacers.
- Ultrasound biomicroscopy revealed posterior cyclodialysis cleft closure, necessitating tube shunt surgery.
Conclusions:
- Cyclodialysis cleft closure is a potential complication of suprachoroidal spacer implantation.
- This closure can lead to abrupt and significant IOP elevation.
- Vigilant monitoring and timely ultrasound biomicroscopy are essential for managing this complication.
