Abstract
BACKGROUND: Traumatic choroidal avulsion combined with cyclodialysis cleft is a severe form of ocular trauma that frequently leads to profound vision loss and persistent hypotony. Conventional surgical approaches often fail to achieve stable anatomical reattachment. This study aimed to evaluate the efficacy and safety of a modified cyclodialysis suturing technique combined with sodium hyaluronate injection for repairing traumatic choroidal avulsion and cyclodialysis cleft. METHODS: This retrospective study included 12 patients (mean age: 47.17 ± 15.84 years) with choroidal avulsion and ciliary body detachment who underwent vitrectomy, sodium hyaluronate injection into the vitreous cavity prior to cyclodialysis repair to facilitate choroidal repositioning, and modified internal cyclopexy. Main outcome measures included anatomical reattachment rate of the choroid and ciliary body (assessed by ultrasound biomicroscopy), best-corrected visual acuity, intraocular pressure, and surgical complications. Follow-up was at least 6 months. RESULTS: Anatomical success (complete reattachment of choroid and closure of cyclodialysis cleft) was achieved in 10 of 12 eyes (83.3%). The best-corrected visual acuity improved significantly from 2.90 ± 0.04 logMAR preoperatively to 2.60 ± 0.13 at 6 months (p = 0.019). Intraocular pressure increased from 8.92 ± 1.68 mmHg to 12.25 ± 2.96 mmHg at 6 months (p = 0.003). No serious intraoperative or postoperative complications occurred. CONCLUSION: The modified cyclodialysis suturing technique combined with sodium hyaluronate injection is a safe and effective approach for repairing traumatic choroidal avulsion and cyclodialysis cleft, offering high anatomical success and significant improvement in visual acuity and intraocular pressure. This method provides a valuable surgical option for this challenging condition. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40942-025-00796-w.