[Hemorrhagic Descemet's membrane detachment after viscocanalostomy].
BACKGROUND
Viscocanalostomy is an option in the surgical treatment of glaucoma. This non-penetrating technique favours aqueous drainage through the Schlemm channel while avoiding filtering blebs and their related pathologies. Complications associated to this surgery are unusual, one of which is Decemet's membrane detachment (DMD) CLINICAL CASE: A 64 year-old female diagnosed with open-angle chronic glaucoma, whose had undergone a viscocanalostomy of the left eye. In the immediate postoperative period we noticed a hemorrhagic DMD in the lower temporal quadrant. After adopting a wait and see attitude, we did not find improvement 15 days after surgery and corneal edema was established with vision decrease. We proceeded to a surgical reapplication by means of Descemet's membrane micropuncture and SF6 injection into the anterior chamber and achieving an anatomical and functional improvement


CONCLUSIONS
We believe that the intrusion of viscoelastic material into the supradescemetic was a consequence of the high-pressure during the high-density hyaluronate injection. Hemorrhagic DMD management is mainly determined by its location, size and evolution. In our case, the posterior endothelial micropuncture and descematopexy by means of 20% SF6 injection into the anterior chamber was useful in resolving this complication.
Gallego-Pinazo
R
R
Hospital Universitario La Fe, Valencia, España. robertogallego@comv.es
López-Sánchez
E
E
Marín-Montiel
J
J
D000867:Anterior Chamber; D003131:Combined Modality Therapy; D015715:Corneal Edema / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D003519:Cyclopentolate / Q000627:therapeutic use; D003886:Descemet Membrane / Q000473:pathology*; D003907:Dexamethasone / Q000627:therapeutic use; D005130:Eye Hemorrhage / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D005260:Female; D018463:Filtering Surgery; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D056965:Injections, Intraocular; D008875:Middle Aged; D009184:Mydriatics / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology*; D011677:Punctures; D013459:Sulfur Hexafluoride / Q000008:administration & dosage
D009184:Mydriatics; D003907:Dexamethasone; D006820:Hyaluronic Acid; D003519:Cyclopentolate; D013459:Sulfur Hexafluoride