|Year : 1981 | Volume
| Issue : 3 | Page : 171-172
Annular posterior cyclodialysis
Department Ophthalmology, 1-Jhansi Road, Gwalior, India
Department of Ophthalmology, J.A. Hospital Gwalior
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shukla B. Annular posterior cyclodialysis. Indian J Ophthalmol 1981;29:171-2
Traumatic cyclodialysis may occur rarely after a severe trauma and in such cases the ciliary body is torn from its anterior scleral attachment. In cyclodialysis operation for aphakic glaucoma the ciliary body is detached from its anterior attachment to scleral spur. Choroidal detachment after cataract operation is commonly seen. In such cases the ciliary body may also get detached from the srlera. Clinically theree types of cilio-choroidal detachment occur-annular, lobular and flat. In annular detachment wave line folds are seen in the choroid immediately behind the ora and running concentrically with limbus.
A rare case has been observed in which the ciliary body was found completely detached posteriorly from ora serrata and floating freely behind the iris.
Case Report : A.K., 50 years male a constable in M. P. police was seen at J.A. Hospital, Gwalior with the complaints of loss of vision in the left eve following a gun shot wound and diminution of vision in the right eye from the same period. The history of trouble in the right eye is as follows :- Patient noted gradual diminution of vision in the right eye since 1971. He was diagnosed as a case of cataract and was advised operation. On 21.3.78 he was operated for cataract. He developed hyphaema and iridocyclitis due to acidental injury soon after the operation and remained for 18 days in the hospital. He was discharged with no improvement in vision and slight pain in the right eye. ,
After months he was admited as a case of post-operative uveitis with occlusio pupillae. A photo-iridectomy was done with xenon arc photocoagulator and was discharged after a week with the following condition :- Vision perception of light A.C. shallow with exudates, Pupil dilated and fixed, Tension slightly raised and diffuse red glow seen on funds examination. After 15 days he was admitted as a case of aphakic glaucoma with post-operative iridocyclitis. Intraocular tension was 30.4 mm Hg. Trabeculectomy with iridectomy was done at Indore. After 3 months he was readmitted in this hospital with the following finding :- Vision C.F. 1', cornea hazy, pupil dilatad and fixed. An annular yellowish band seen behind the iris floating freely. Tension was normal but slight tenderness was present. Diffuse red glow seen on funds examination.
After a follow up of further 3 months the findings were same as before. Vision in the right eye improved to C.F. 3' with+ 10.0D Sph glass. The yellowish folds were more prominent on temporal side in abduction and more prominent on the nasal side on adduction.
| Discussion|| |
Detachment of the ciliary body, whether traumatic or operative, is usually from the anterior attachment at the scleral spur. In cilio-choroidal detachment after intra-ocular operations the detachment of ciliary body occurs from overlying sclera and not from scleral spur or ora serrata. A complete posterior detachment from ora serrata is a rarity and has not been reported so far to the best of our knowledge.
Besides the rarity of the case another point of interest is the possible mechanism of posterior detachment. A number of operations were performed on the affected eye including lens extraction, trabeculectomy and photo-iridectomy in addition to various local medicaments. The patient also had mechanical trauma to the eye after the first operations could it be due to summation of the effects of three operative procedures or due to summation of operative and mechanical trauma?
Photo-iridectomy is a relatively a now procedure and the experience in this field is limited. O'Malley' has cautioned that damage may occur to cornea by scattering or absorption of light. Uveal tissue is rich in pigments and absorbs light. Could such absorption affect ora serrata leading to a tear in that region.
No definite answer can be given at this stage for this peculiar complication. There may be some change in the accommodative power also which however could not be studied in this case due to very low vision.
| Summary|| |
A rare case of total posterior detachment of ciliary body (annular posterior cyclodialysis) has been described in an adult male who underwent three operation. Its possible mechanism has been discussed.
| Acknowledgements|| |
I wish to thank Dr. M.S. Choudary, Dean and Dr. M.L. Agarwal, Professor of Opthalmology, G.R. Medical College, Gwalior for their kind permission and help in preparing this paper.
| References|| |
O'Malley, 1974, Portable xenon are light coagulator-Theory & Practice Instruction Course, American Academy of Ophtholmology & Otolaryngology, P. 15.