title: Novel Treatment for Hemorrhagic Descemet Detachment After Canaloplasty.
abstract: OBJECTIVE
  To describe a case of hemorrhagic Descemet membrane detachment after canaloplasty and to discuss its management using alteplase, a tissue plasminogen activator (TPA).
  
  
  METHODS
  Interventional case report.
  
  
  RESULTS
  A 60-year-old woman with advanced pseudoexfoliation glaucoma developed severe hemorrhagic Descemet detachment after canaloplasty. Initial anterior chamber and pre-Descemet washout yielded no improvement. On the fifth postoperative day, the patient received a novel pre-Descemet treatment using a TPA with an anterior chamber air bubble. The intracorneal blood clot quickly dissolved intraoperatively with the Descemet membrane almost completely reattached on postoperative day 1.
  
  
  CONCLUSIONS
  Hemorrhagic Descemet detachment is a rare and serious complication of canaloplasty. The use of pre-Descemet TPA dissolves the intracorneal blood clot and helps reattach Descemet membrane, allowing quick rehabilitation of patient's vision and preserving integrity of the cornea.
authors.affiliation: Department of Ophthalmology, University of Montreal, Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Hamid
authors.forename: Paul
authors.initials: P
authors.lastname: Thompson
authors.forename: Paul
authors.initials: P
authors.lastname: Harasymowycz
mesh_terms: D003316:Corneal Diseases / Q000188:drug therapy* / Q000209:etiology; D003886:Descemet Membrane / Q000293:injuries*; D017889:Exfoliation Syndrome / Q000601:surgery; D005130:Eye Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D018463:Filtering Surgery / Q000009:adverse effects*; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012421:Rupture; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator