What is Going on Here? (Malik Y. Kahook, MD)

This is a unique case of traumatic ciliary body cleft formation with episodic bleeding from a torn iris vessel. The interesting aspect was the lack of layered hyphema (with blood collecting in the cleft rather than in the anterior chamber) and the episodic nature of the bleeding due to reversible plugging of the cleft by iris tissue.
#Trauma #Hyphema #Cataract #Iris #Mystery #Surgery #Cleft #Ophthalmology #Eye

[@kamranrahmatnejad5640]

Very interesting case! Really unique. Thanks for sharing.

[@abhijithholla4544]

Good one sir loved it...

[@andrewrabinowitz5685]

Malik. This is an awesome diagnosis on your part. The slit-lamp video is incredible and very revealing. I have seen cases with intermittent micro-hyphema many years following a trauma which lead to cataract extraction with AC IOL placement (a long time ago). We hypothesized that the patient had a recurrent iris bleed, and noted a cleft, but were unable to capture the moment(s) when the patient was bleeding, and never thought to consider that the iris would intermittently plug the cleft which in retrospect is likely what was happening. You have solved a mystery that had stumped me for many years. One question of curiosity, was what was the IOP when they presented, and did the IOP rise following closure of the cleft? Thanks. Andrew Rabinowitz

[@malikkahook9368]

Thank you, Andrew. The IOP was low teens when he presented and he did spike post closure...but he came back down on meds and remains on one drop today. Doing well. I will see if I can find his surgical video to post on youtube at some point.

[@andrewrabinowitz5685]

@@malikkahook9368 Malik, thank you. I am certain that everyone who follows your work would benefit (myself included) from seeing how you closed the cleft. This is a procedure which most surgeons have little to no experience with. Thanks. Andrew

[@malikkahook9368]

Here is a lecture on how we close these cleft... czcams.com/video/akY2BA25g8M/video.html

[@metemia6640]

What is the treatment for this disease?

[@rotastrain]

Is it possible to post the surgical video of this case for repair of the cleft.

[@malikkahook9368]

www.keogt.com/Repair_of_Cyclodialysis_Clefts see figure 28-3 for the technique we use. I will try to post the actually surgery at some point in the future.

[@malikkahook9368]

Here is a lecture on how we close these cleft... czcams.com/video/akY2BA25g8M/video.html

[@jeremieagre6238]

How did you repair the cleft? A video will be helpful

[@malikkahook9368]

www.keogt.com/Repair_of_Cyclodialysis_Clefts see figure 28-3 for the technique we use. I will try to post the actually surgery at some point in the future.

[@malikkahook9368]

Here is a lecture on how we close these cleft... czcams.com/video/akY2BA25g8M/video.html