Hypotony following Cyclodialysis.

SUCCESSFUL results of cyclodialysis as an operation for glaucoma were first reported by Heine (1905). It is a method whereby a communication is made between the suprachoroidal space and the anterior chamber, by breaking down the attachment of the ciliary body to the scleral spur. Heine designed the operation following a report by Fuchs (1900), wherein he described the finding of separation of the ciliary body in hypotonic eyes which had developed choroidal separation following cataract extraction. He assumed that the cause of the choroidal detachment was a flow of intra-ocular fluid from the anterior chamber to the supra-choroidal space. Cyclodialysis is an operation which is not effective in eyes with an acutely raised pressure, and in recent years has been used as an elective procedure in aphakic glaucoma with a closed angle. It also has a place as an adjunct to other operations, and has been widely employed when a basal iridectomy has failed to produce long-term control of closed-angle glaucoma. One of the complications of cyclodialysis is hypotony, and this may be produced in extreme degree so that it is impossible to record the ocular tension with a Schi6tz tonometer. Vision is poor immediately after the operation, and examination of the eye reveals a shallow anterior chamber and oedema of the choroidal tissues so that the retina is raised in undulations extending backwards to the posterior pole, where the disc is found to be swollen.