Encircling Scleral Buckling for Traumatic Severe Hypotony

The authors report the use of an encircling scleral buckling procedure for the management of severe hypotony secondary to traumatic annular ciliochoroidal detachment (CCD) with cyclodialysis cleft. Medical records of patients with severe ocular hypotony were retrospectively reviewed. Four patients with traumatic annular CCD with cyclodialysis cleft were identified. Diagnosis of CCD was documented by ultrasound biomicroscopy and presence of cyclodialysis cleft was confirmed by gonioscopy or ultrasound biomicroscopy. All patients underwent scleral buckling surgery with an encircling band for annular CCD with cyclodialysis cleft. Intraocular pressure (IOP) and visual acuity (VA) significantly improved post-operatively. Mean IOP changed from 2.5 mm Hg +/- 0.5 mm Hg to 10.75 mm Hg +/- 1.1 mm Hg (P =.0129) and mean best-corrected VA changed from +0.50 +/- 0.16 logMAR to +0.15 +/- 0.17 logMAR (P =.0123). IOP normalization was achieved despite persistence of CCD. These results support the use of scleral buckling with an encircling band as an effective approach for severe hypotony in patients with annular CCD regardless the cyclodialysis cleft extension.