DIAGNOSIS OF TRAUMATIC CYCLODIALYSIS BY ULTRASOUND BIOMICROSCOPY

BACKGROUND AND OBJECTIVE: To evaluate the ability of high-frequency ul trasound biomicroscopy to diagnose traumatic cyclodialyses not evident on clinical examination. PATIENTS AND METHODS: Six eyes of six patien ts with posttraumatic hypotony and/or shallow anterior chamber and sus pected cyclodialysis clefts were examined with slit-lamp biomicroscopy , gonioscopy, B-scan ultrasonography, and ultrasound biomicroscopy. Ul trasound biomicroscopy provided high resolution of cross-sectional ima ges of the anterior chamber angle, posterior chamber, and anterior uve al tissue. RESULTS: Ultrasound biomicroscopy confirmed the disinsertio n of the ciliary body from the scleral spur and associated ciliary bod y detachment in all eyes. Gonioscopy failed to demonstrate a cyclodial ysis cleft in five eyes because of hyphema (two eyes) and abnormal iri s architecture (related to trauma) precluding visualization of the ang le recess (three eyes). Using information from ultrasound biomicroscop y imaging, one patient underwent a ciliary body reattachment procedure and repair of the cyclodialysis cleft. CONCLUSION: Ultrasound biomicr oscopy is a noninvasive method that can accurately diagnose the presen ce of traumatic cyclodialyses and can aid in surgical management; It i s particularly useful in the presence of hazy media, hypotony, and/or abnormal anterior segment anatomy.