Hemorrhagic descemet membrane detachment after classic canaloplasty.
OBJECTIVE
Canaloplasty is a safe and effective alternative in glaucoma surgery, avoiding the risk for hypotony and bleb-related complications. Two cases of hemorrhagic Descemet membrane detachment (DMD) after canaloplasty are reported in patients who did not have previous surgery.


RESULTS
Two patients with primary open-angle glaucoma underwent canaloplasty because of medically uncontrolled intraocular pressure (IOP). Canaloplasty was performed using a flexible microcatheter, viscoelastic material and a tensioning suture. The day after surgery, hemorrhagic DMD was observed in the inferior quadrants in both patients on slit-lamp biomicroscopy.


METHODS
For the size and location (occlusion of the visual axis), aspiration of blood and descemetopexy with air tamponade were performed promptly. In both cases, a small translucent scar remained.


CONCLUSIONS
Circumferential cannulation and viscodilation of the Schlemm canal increases the risk for DMD, which may be aggravated by blood reflux resulting from the tensioning suture and low postoperative IOP. Surgeons should be aware of this specific and potentially sight-threatening complication in classic canaloplasty. Immediate intervention is recommended for good visual prognosis.
Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman: Josef Flammer).
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LM
Brandao
Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman: Josef Flammer).
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S
Orgul
Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman: Josef Flammer).
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MC
Grieshaber
D000368:Aged; D003886:Descemet Membrane / Q000293:injuries* / Q000601:surgery*; D005130:Eye Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D018463:Filtering Surgery / Q000009:adverse effects*; D005901:Glaucoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome