睫状体解离诊断和治疗进展

doi:10.3760/cma.j.cn115909-20201010-00384

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摘要

睫状体解离是指附着在巩膜突上的睫状体纵行肌断裂，睫状体与巩膜突分离，导致前房与睫状体上腔相通，为房水引流创造了异常途径，引起持续性的低眼压及其他眼部病变。持续性低眼压可引起白内障进展、屈光改变、视盘水肿及一系列视网膜并发症，需及时、准确地进行干预。目前除房角镜检查外，超声生物显微镜、眼前节光学相关断层扫描、磁共振成像及示踪染料法也可应用于睫状体解离的诊断。药物、激光光凝术及睫状体冷冻疗法等保守治疗方法可用于关闭小范围解离，大多数睫状体解离情况需要进行手术治疗。现笔者主要对国内外睫状体解离诊断及治疗方法进行综述。关键词：睫状体解离；诊断；治疗；外伤性低眼压；眼球顿挫伤

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关键词 ：睫状体解离, 诊断, 治疗, 外伤性低眼压, 眼球顿挫伤

Abstract：

Cyclodialysis refers to the rupture of the ciliary body longitudinal muscle attached to the scleral process.

The separation of the ciliary body from the scleral process leads to the connection between the anterior

chamber and the supra ciliary body, which creates abnormal aqueous humor drainage and causes

persistently low intraocular pressure and other ocular diseases. Hypotony produces secondary complications

such as cataract, refractive changes, optic disc oedema and a series of retinopathies. Therefore, timely and

accurate intervention is needed. When the cause is complex, there may be more than one cleft, or even

other eye injuries. At present, ultrasonic biological microscopy, optical tomography of the anterior segment,

magnetic resonance imaging and the tracer dye method can be used in the diagnosis of cyclodialysis.

Conservative therapies such as drugs, laser photocoagulation, and ciliary body cryotherapy can be used to

close a small range of dissociation but most cases are treated surgically. This paper mainly reviews recent

research progress on cyclodialysis both domestically and abroad.

Key words： cyclodialysis diagnose treatment hypotony ocular contusion

收稿日期: 2020-10-10

PACS:

基金资助:

国家自然科学基金（81970776，81671844）；黑龙江省医学科学院科研转化专项基金（CR201809）

通讯作者: 张弘（ORCID：0000-0003-4179-5666），Email：13804505456@163.com

引用本文:

高嘉悦张弘. 睫状体解离诊断和治疗进展[J]. 中华眼视光学与视觉科学杂志, 2022, 24(2): 155-160. Jiayue Gao, Hong Zhang. Recent Progress in the Diagnosis and Treatment of Cyclodialysis. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(2): 155-160. DOI: 10.3760/cma.j.cn115909-20201010-00384

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20201010-00384 或 https://www.cjoovs.com/CN/Y2022/V24/I2/155

[1]	Ioannidis AS, Barton K. Cyclodialysis cleft: causes and repair.Curr Opin Ophthalmol, 2010, 21(2): 150-154. DOI: 10.1097/ICU.0b013e3283366a4d.
[2]	Popovic M, Shareef S, Mura JJ, et al. Cyclodialysis cleft repair:a multi-centred, retrospective case series. Clin Exp Ophthalmol,2019, 47(2): 201-211. DOI: 10.1111/ceo.13378.
[3]	周军, 庞秀琴, 刘毅, 等. 外伤性睫状体解离复位手术失败的原因分析. 眼科, 2015, 24(4): 246-249. DOI: 10.13281/j.cnki.issn.1004-4469.2015.04.007.
[4]	张贵森, 宋立新. 外伤性睫状体脱离内路缝合复位术一例.中华眼外伤职业眼病杂志, 2017, 39(12): 954-955. DOI: 10.3760/cma.j.issn.2095-1477.2017.12.019.
[5]	李海波, 颜华, 蔡锦红, 等. 30G针头辅助下连续褥式缝合治疗外伤性睫状体离断. 眼科新进展, 2019, 39(7): 640-644.DOI: 10.13389/j.cmki.rao.2019.0147.
[6]	李松涛, 张红鸽. 睫状体复位手术联合玻璃体腔注射曲安奈德治疗睫状体分离合并黄斑水肿的疗效观察. 中华眼底病杂志, 2014, 30(4): 407-409. DOI: 10.3760/cma.j.issn.1005-1015.2014.04.019.
[7]	杨文利. 应用超声生物显微镜检查及诊断眼部睫状体脱离.中华眼科杂志, 1999, 35(3): 194. DOI: 10.3760/j:issn:0412-4081.1999.03.010.
[8]	Grosskreutz C, Aquino N, Dreyer EB. Cyclodialysis. Int Ophthalmol Clin, 1995, 35(1): 105-109. DOI: 10.1097/00004397-199503510-00011.
[9]	Wang Q, Thau A, Levin AV, et al. Ocular hypotony: a comprehensive review. Surv Ophthalmol, 2019, 64(5): 619-638.DOI: 10.1016/j.survophthal.2019.04.006.
[10]	Hwang JM, Ahn K, Kim C, et al. Ultrasonic biomicroscopic evaluation of cyclodialysis before and after direct cyclopexy.
	Arch Ophthalmol, 2008, 126(9): 1222-1225. DOI: 10.1001/archopht.126.9.1222.
[11]	Razeghinejad MR, Dehghani C. Effect of ocular hypotony secondary to cyclodialysis cleft on corneal topography. Cornea,2008, 27(5): 609-611. DOI: 10.1097/ICO.0b013e3181656477.
[12]	González-Martín-Moro J, Contreras-Martín I, Muñoz-Negrete FJ, et al. Cyclodialysis: an update. Int Ophthalmol, 2017, 37(2):
44	1-457. DOI: 10.1007/s10792-016-0282-8.
[13]	Gupta S, Selvan H, Agrawal S, et al. Dynamic gonioscopy and ultrasound biomicroscopy for diagnosis of latent or low-lying
	cyclodialysis clefts. Clin Exp Ophthalmol, 2018, 46(8): 960-962. DOI: 10.1111/ceo.13316.
[14]	Andreatta W, Agrawal P, Shah P. Identification of postgonioscopy hypotony: a simple clinical test to help diagnose occult cyclodialysis clefts. Ophthalmic Physiol Opt, 2015,35(2): 242. DOI: 10.1111/opo.12173.
[15]	Abdul-Rahman A. Retraction gonioscopy: a novel method in the diagnosis of cyclodialysis clefts. Clin Exp Ophthalmol, 2018,46(7): 833-835. DOI: 10.1111/ceo.13175.
[16]	Sihota R, Kumar S, Gupta V, et al. Early predictors of traumatic glaucoma after closed globe injury: trabecular pigmentation,
	widened angle recess, and higher baseline intraocular pressure.Arch Ophthalmol, 2008, 126(7): 921-926. DOI: 10.1001/archopht.126.7.921.
[17]	Zhao R, Lou B, Yang Y, et al. Risk Factors Associated with Failure of Direct Cyclopexy in the Treatment of Small to Moderate Tramatic Cyclodialysis Clefts. Curr Eye Res, 2020,45(7): 797-804. DOI: 10.1080/02713683.2019.1698052.
[18]	Selvan H, Yadav S, Gupta V, et al. Case Report: Cyclodialysis Cleft in a Case of Open-globe Injury and Role of Swept-source
	Anterior Segment Optical Coherence Tomography in Diagnosis.Optom Vis Sci, 2020, 97(6): 395-399. DOI: 10.1097/OPX.0000000000001518.
[19]	Gross JB, Davis GH, Bell NP, et al. Surgical repair of large cyclodialysis clefts. Eur J Ophthalmol, 2017, 27(3): 382-385.DOI: 10.5301/ejo.5000868.
[20]	郑东萍, 戴昳宁, 米立, 等. 眼前节光学相干断层扫描引导眼钝伤所致睫状体断离复位手术的应用. 中华医学杂志, 2018,98(48): 3921-3924. DOI: 10.3760/cma.j.issn.0376-2491.2018.48.003.
[21]	Jeong JH, Jeoung JW, Moon NJ. Magnetic Resonance Imaging of Cyclodialysis Cleft Before and After Cyclopexy. J Glaucoma,2017, 26(1): e15-e18. DOI: 10.1097/IJG.0000000000000438.
[22]	Khoo YJ, Abdullah A, Yu DY, et al. Use of trypan blue as an aqueous tracer dye to investigate hypotony where cyclodialysis
	cleft is suspected. Clin Exp Ophthalmol, 2019, 47(7): 904-908.DOI: 10.1111/ceo.13558.
[23]	Ormerod LD, Baerveldt G, Sunalp MA, et al. Management of the hypotonous cyclodialysis cleft. Ophthalmology, 1991, 98(9):1384-1393. DOI: 10.1016/s0161-6420(91)32121-3.
[24]	Aminlari A, Callahan CE. Medical, laser, and surgical management of inadvertent cyclodialysis cleft with hypotony.Arch Ophthalmol, 2004, 122(3): 399-404. DOI: 10.1001/archopht.122.3.399.
[25]	Selvan H, Gupta V, Gupta S. Cyclodialysis: an updated approach to surgical strategies. Acta Ophthalmol, 2019, 97(8): 744-751.
	DOI: 10.1111/aos.14210.
[26]	Han JC, Kwun YK, Cho SH, et al. Long-term outcomes of argon laser photocoagulation in small size cyclodialysis cleft. BMC
	Ophthalmol, 2015, 15: 123. DOI: 10.1186/s12886-015-0113-0.
[27]	Abdul-Rahman A, House P, Richards J. Intraocular lens dystrophic calcification after trans-scleral diode laser treatment for a cyclodialysis cleft. Am J Ophthalmol Case Rep, 2018, 11:78-83. DOI: 10.1016/j.ajoc.2018.06.012.
[28]	Popovic M, Shareef S, Mura JJ, et al. Cyclodialysis cleft repair: a multi-centred, retrospective case series-Response. Clin Exp Ophthalmol, 2019, 47(2): 304-308. DOI: 10.1111/ceo.13427.
[29]	Trikha S, Turnbull A, Agrawal S, et al. Management challenges arising from a traumatic 360 degree cyclodialysis cleft. Clin Ophthalmol, 2012, 6: 257-260. DOI: 10.2147/OPTH.S29123.
[30]	Hoerauf H, Roider J, Laqua H. Treatment of traumatic cyclodialysis with vitrectomy, cryotherapy, and gas endotamponade. J Cataract Refract Surg, 1999, 25(9): 1299-1301. DOI: 10.1016/s0886-3350(99)00160-1.
[31]	Ioannidis AS, Bunce C, Barton K. The evaluation and surgical management of cyclodialysis clefts that have failed to respond
	to conservative management. Br J Ophthalmol, 2014, 98(4):544-549. DOI: 10.1136/bjophthalmol-2013-303559.
[32]	Agrawal P, Shah P. Long-term outcomes following the surgical repair of traumatic cyclodialysis clefts. Eye (Lond), 2013,27(12): 1347-1352. DOI: 10.1038/eye.2013.183.
[33]	Carvalho LS, Knott B, Berg ML, et al. Ultraviolet-sensitive vision in long-lived birds. Proc Biol Sci, 2011, 278(1702): 107-114. DOI: 10.1098/rspb.2010.1100.
[34]	Nagashima T, Kohmoto R, Fukumoto M, et al. Ciliary body suturing using intraocular irrigation for traumatic cyclodialysis:
	two case reports. J Med Case Rep, 2020, 14(1): 121. DOI:10.1186/s13256-020-02448-z.
[35]	刘鹏飞. 改良式外伤性睫状体解离缝合复位术的临床研究.国际眼科杂志, 2020, 20(1): 171-173. DOI: 10.3980/j.issn.1672-5123.2020.1.41.
[36]	Gupta S, Selvan H, Kishan A, et al. Single-point pivot for combined repair of concurrent iridodialysis and cyclodialysis. J Cataract Refract Surg, 2018, 44(11): 1306-1309. DOI: 10.1016/j.jcrs.2018.08.004.
[37]	Gupta S, Selvan H, Shakrawal J, et al. One-step management of post-traumatic triple dialysis using two rings. Eur J Ophthalmol,2019, 29(5): NP9-NP13. DOI: 10.1177/1120672118803520.
[38]	Chadha N, Lamba T, Belyea DA, et al. Indirect cyclopexy for treatment of a chronic traumatic cyclodialysis cleft with hypotony. Clin Ophthalmol, 2014, 8: 591-594. DOI: 10.2147/OPTH.S55938.
[39]	Feiler DL, Browne AW, Rachitskaya AV, et al. Indirect Cyclopexy for Repair of Cyclodialysis Clefts. Retina, 2019, 39 Suppl 1: S177-S181. DOI: 10.1097/IAE.0000000000002091.
[40]	Wang C, Peng XY, You QS, et al. Internal cyclopexy for complicated traumatic cyclodialysis cleft. Acta Ophthalmol,2017, 95(6): 639-642. DOI: 10.1111/aos.13463.
[41]	Gupta S, Selvan H, Gupta V. Single-suture single-knot ab interno cyclopexy for extensive posttraumatic cyclodialysis:Modified sewing machine technique. J Cataract Refract Surg,2019, 45(1): 3-7. DOI: 10.1016/j.jcrs.2018.08.031.
[42]	Huang L, Zhang Q, Jin H. Intrascleral sewing-machine technique: a Grooveless/flapless cyclopexy technique for large
	traumatic Cyclodialysis cleft repairs in pars plana vitrectomy.Retina, 2020, DOI: 10.1097/IAE.0000000000002772.
[43]	Gupta S, Sagar P, Gogia V, et al. Dual Endotemponade for Extensive Long-standing Cyclodialysis Using Sulcus-fixated
	Cionni Ring and PCIOL. J Glaucoma, 2016, 25(3): e284-287.DOI: 10.1097/IJG.0000000000000334.
[44]	Shentu X, Zhu Y, Tang Y. Closure of a persistent cyclodialysis cleft using the haptics of a normal-sized intraocular lens. BMJ
	Case Rep, 2011, 2011. bcr0720114555. DOI: 10.1136/bcr.07.2011.4555.
[45]	Yuen NS, Hui SP, Woo DC. New method of surgical repair for 360-degree cyclodialysis. J Cataract Refract Surg, 2006, 32(1):
13	-17. DOI: 10.1016/j.jcrs.2005.05.035.
[46]	Chen J, Jing Q, Gao W, et al. Cyclodialysis cleft repair and cataract management by phacoemulsification combined with internal tamponade using modified capsular tension ring insertion. Graefes Arch Clin Exp Ophthalmol, 2018, 256(12):
23	69-2376. DOI: 10.1007/s00417-018-4149-8.
[47]	Pinheiro-Costa J, Melo AB, Carneiro ÂM, et al. Cyclodialysis cleft treatment using a minimally invasive technique. Case Rep
	Ophthalmol, 2015, 6(1): 66-70. DOI: 10.1159/000375442.
[48]	Xu WW, Huang YF, Wang LQ, et al. Cyclopexy versus vitrectomy combined with intraocular tamponade for treatment
	of cyclodialysis. Int J Ophthalmol, 2013, 6(2): 187-192. DOI:10.3980/j.issn.2222-3959.2013.02.16.