外傷性毛様体解離裂に対する硝子体切除術を伴う間接強膜直接毛様体固定術に関する眼の外傷研究

To evaluate the surgical efficacy and functional outcomes of gonioscopy-guided transscleral direct cyclopexy (GTS direct cyclopexy) for repairing traumatic cyclodialysis clefts.

This study included 20 eyes of 20 patients with traumatic cyclodialysis. GTS direct cyclopexy was performed using a curved needle with 10 - 0 polypropylene suture to close the cleft, with gonioscopy guidance for precise localization and closure confirmation. Additional procedures such as vitrectomy were performed as needed. Clinical data, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ultrasound biomicroscopy (UBM) findings, were collected preoperatively and at regular follow-up visits. Statistical analyses were performed using the Wilcoxon matched-pairs signed-rank test.

Cyclodialysis closure was achieved in 19 of 20 eyes (95%) after a single GTS direct cyclopexy. The median extent of cyclodialysis was 60° (IQR: 34°-113°). BCVA significantly improved from 1.74 ± 0.98 logMAR preoperatively to 0.90 ± 0.69 logMAR at 6 months postoperatively (p = 0.002). IOP increased from a mean of 6.1 ± 2.8 mmHg to 12.63 ± 3.60 mmHg at 6 months (p = 0.0007). Postoperative IOP spikes were observed in 4 patients (20%) but were managed successfully. No cataracts related to the surgery were reported.

GTS direct cyclopexy is a safe, minimally invasive, and repeatable for repairing traumatic cyclodialysis clefts.