Modified cyclodialysis suturing with sodium hyaluronate for traumatic choroidal avulsion and cyclodialysis: a retrospective study

TL;DR

A new surgical technique using sodium hyaluronate improves outcomes for severe eye injuries involving choroidal avulsion and cyclodialysis.

Contribution

A modified cyclodialysis suturing technique combined with sodium hyaluronate injection is introduced for traumatic choroidal avulsion.

Findings

Anatomical success was achieved in 83.3% of cases with choroidal reattachment and cyclodialysis closure.

Visual acuity improved significantly from 2.90 to 2.60 logMAR at 6 months post-surgery.

Intraocular pressure increased from 8.92 mmHg to 12.25 mmHg at 6 months with no major complications.

Abstract

Traumatic choroidal avulsion combined with cyclodialysis cleft is a severe form of ocular trauma that frequently leads to profound vision loss and persistent hypotony. Conventional surgical approaches often fail to achieve stable anatomical reattachment. This study aimed to evaluate the efficacy and safety of a modified cyclodialysis suturing technique combined with sodium hyaluronate injection for repairing traumatic choroidal avulsion and cyclodialysis cleft.

This retrospective study included 12 patients (mean age: 47.17 ± 15.84 years) with choroidal avulsion and ciliary body detachment who underwent vitrectomy, sodium hyaluronate injection into the vitreous cavity prior to cyclodialysis repair to facilitate choroidal repositioning, and modified internal cyclopexy. Main outcome measures included anatomical reattachment rate of the choroid and ciliary body (assessed by ultrasound biomicroscopy), best-corrected visual acuity, intraocular pressure, and surgical complications. Follow-up was at least 6 months.

Anatomical success (complete reattachment of choroid and closure of cyclodialysis cleft) was achieved in 10 of 12 eyes (83.3%). The best-corrected visual acuity improved significantly from 2.90 ± 0.04 logMAR preoperatively to 2.60 ± 0.13 at 6 months (p = 0.019). Intraocular pressure increased from 8.92 ± 1.68 mmHg to 12.25 ± 2.96 mmHg at 6 months (p = 0.003). No serious intraoperative or postoperative complications occurred.

The modified cyclodialysis suturing technique combined with sodium hyaluronate injection is a safe and effective approach for repairing traumatic choroidal avulsion and cyclodialysis cleft, offering high anatomical success and significant improvement in visual acuity and intraocular pressure. This method provides a valuable surgical option for this challenging condition.

The online version contains supplementary material available at 10.1186/s40942-025-00796-w.

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