{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:26:31Z","timestamp":1762543591635,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,12,30]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>We present a previously undescribed case of a persistent hypotony maculopathy secondary to an iatrogenic cyclodialysis cleft created during XEN-45 gel stent insertion. We present this case as a further analysis of the <jats:italic>Karimi et al<\/jats:italic> case of cyclopexy by the corresponding surgeon. Following right XEN-45 implantation, our patient developed immediate and persistent postoperative hypotony for 4\u2009weeks. Gonioscopy revealed a small cyclodialysis cleft at the 1\u20132 o\u2019clock position. The cyclodialysis cleft was sealed with direct gonioscopic argon laser cyclopexy. Two months after laser treatment and total of 6\u2009months post XEN-45 insertion, right eye visual acuity returned to 6\/4 with intraocular pressure 11\u2009mm Hg without any glaucoma medication. Here, we present details of the non-invasive safe and successful management of hypotony maculopathy secondary to the cleft using Argon laser gonio cyclopexy, with no requirement of return to theatre.<\/jats:p>","DOI":"10.1136\/bcr-2021-244933","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T11:36:20Z","timestamp":1646739380000},"page":"e244933","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["XEN-related hypotonous maculopathy from iatrogenic cyclodialysis cleft treated with argon laser gonio-cyclopexy"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1184-1991","authenticated-orcid":false,"given":"Lamia","family":"Hamidovic","sequence":"first","affiliation":[{"name":"The Colchester Eye Centre of Excellence, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tasneem","family":"Khatib","sequence":"additional","affiliation":[{"name":"The Colchester Eye Centre of Excellence, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrysostomos","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"The Colchester Eye Centre of Excellence, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9607-6661","authenticated-orcid":false,"given":"Zhiheng","family":"Lin","sequence":"additional","affiliation":[{"name":"The Colchester Eye Centre of Excellence, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"key":"2025082712302404000_15.3.e244933.1","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/j.jfo.2018.12.002","article-title":"XEN\u00ae Gel Stent for management of chronic open angle glaucoma: A review of the literature","volume":"42","author":"Buffault","year":"2019","journal-title":"J Fr Ophtalmol"},{"key":"2025082712302404000_15.3.e244933.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0183142","article-title":"Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: a systematic review and meta-analysis","volume":"12","author":"Lavia","year":"2017","journal-title":"PLoS One"},{"key":"2025082712302404000_15.3.e244933.3","doi-asserted-by":"crossref","first-page":"4789","DOI":"10.1167\/iovs.15-16625","article-title":"Fluid dynamics of a novel Micro-Fistula implant for the surgical treatment of 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gel implants for glaucoma, with and without combined cataract surgery","volume":"33","author":"Karimi","year":"2019","journal-title":"Eye"},{"key":"2025082712302404000_15.3.e244933.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12886-015-0113-0","article-title":"Long-term outcomes of argon laser photocoagulation in small size cyclodialysis cleft","volume":"15","author":"Han","year":"2015","journal-title":"BMC Ophthalmol"},{"key":"2025082712302404000_15.3.e244933.9","doi-asserted-by":"crossref","first-page":"74","DOI":"10.5005\/jp-journals-10078-1255","article-title":"Cyclodialysis cleft associated with Kahook dual blade goniotomy","volume":"13","author":"Shue","year":"2019","journal-title":"J Curr Glaucoma Pract"},{"key":"2025082712302404000_15.3.e244933.10","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1097\/IJG.0000000000000719","article-title":"Inadvertent cyclodialysis cleft and hypotony following ab-interno trabeculotomy using the trabectome device requiring surgical repair","volume":"26","author":"Berk","year":"2017","journal-title":"J Glaucoma"},{"key":"2025082712302404000_15.3.e244933.11","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.18240\/ijo.2019.10.23","article-title":"Full-thickness scleral incisions technique for the treatment of a cyclodialysis cleft following ab interno trabeculotomy","volume":"12","author":"Alvarez-Ascencio","year":"2019","journal-title":"Int J Ophthalmol"},{"key":"2025082712302404000_15.3.e244933.12","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1097\/IJG.0000000000001560","article-title":"Persistent hypotony and annular Ciliochoroidal detachment after Microhook ab Interno trabeculotomy","volume":"29","author":"Ishida","year":"2020","journal-title":"J Glaucoma"}],"container-title":["BMJ Case 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