Double-encircling continuous suture technique for complete cyclodialysis: a consecutive case series

PURPOSE: To evaluate the safety and efficacy of a novel double-encircling continuous suture technique for the surgical repair of complete (360°) cyclodialysis. STUDY DESIGN: Retrospective interventional case series. METHODS: Medical records of seven consecutive eyes from seven patients with complete cyclodialysis treated at the University of Tokyo Hospital between 2022 and 2025 were retrospectively reviewed. The extent of cyclodialysis and postoperative anatomical outcomes were assessed using anterior segment optical coherence tomography (OCT). Intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded both pre- and post-operatively. The surgical technique consisted of placing two laps of encircling continuous 10-0 polypropylene sutures at 3-4 mm and 2-3 mm posterior to the limbus. In phakic eyes, phacoemulsification with intraocular lens and capsular tension ring implantation were performed concurrently. RESULTS: Four men and three women with a mean age of 43.6 ± 25.4 years were included. Cyclodialysis resulted from blunt trauma (n = 3) or surgical complications (n = 4). Preoperative IOP ranged from 2 to 8 mmHg, and hypotonic maculopathy was observed in all cases. Postoperatively, anatomical reattachment of the ciliary body and resolution of hypotony were achieved in six of seven eyes (85.7%). All eyes demonstrated improved BCVA, though the improvement depended on comorbid conditions such as glaucoma, pathologic myopia, and bullous keratopathy. IOP transiently elevated postoperatively, and additional glaucoma surgery was necessary in two cases with a history of glaucoma. CONCLUSION: Reproducible safety and efficacy were confirmed for the double-encircling continuous suture technique in repairing complete cyclodialysis, yielding anatomical success and functional improvement.