Cryotherapy in the treatment of cyclodialysis cleft induced hypotony

A 26-year-old man with juvenile glaucoma developed persisting hypotonic retinopathy after trabeculotomy ab externo. An unintended cyclodialysis cleft at the site of the trabeculotomy was suspected, but visualization of the chamber angle was impossible due to a shallow anterior chamber. Seven months after the trabeculotomy the patient was treated with transconjunctival cryotherapy at the presumed localization of a cyclodialysis cleft. Eight days later an episode of acute ocular hypertension occurred, otherwise the postoperative course was uneventful with reversal of the hypotony and complete normalization of the visual acuity. The diagnostic and therapeutic problems of a hypotonous cyclodialysis cleft combined with a shallow anterior chamber are discussed.