Transscleral cryotherapy for 360° cyclodialysis following blunt trauma: A case report

Cyclodialysis is a rare posttraumatic condition whose treatment approaches have yet to reach a standard consensus. This report demonstrates the effectiveness of transscleral cryotherapy for a 360° cyclodialysis cleft after blunt trauma, complicated by hypotony maculopathy. A 22-year-old male presented with blurred vision 4 months after being hit by a shuttlecock. Visual acuity was counting fingers, with intraocular pressure at 4.4 mmHg. Clinical examination revealed chorioretinal folds in the macula. Ultrasound biomicroscopy confirmed a total 360° cyclodialysis cleft. After 8 weeks of treatment with atropine 1%, with only mild reduction of choroidal effusion, the patient underwent transscleral cryotherapy. Four weeks postoperatively, visual acuity improved to 20/20 and intraocular pressure normalized to 14 mmHg. Signs of cyclodialysis cleft, choroidal effusion, and hypotony maculopathy were no longer detected. Transscleral cryotherapy is an effective and safe treatment for extensive posttraumatic cyclodialysis clefts and should be considered before more invasive surgical options.