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Abstract #3660 Published in IGR 4-2
Descemet membrane detachment after nonpenetrating filtering surgery
Ravinet E; Tritten JJ; Roy S; Gianoli F; Wolfensberger T; Schnyder C; Mermoud AJournal of Glaucoma 2002; 11: 244-252
PURPOSE: To make surgeons performing nonpenetrating filtering surgery aware of an unusual complication, namely Descemet membrane detachment. METHODS: The authors retrospectively reviewed nine eyes of nine patients seen in our hospital with Descemet membrane detachment occurring after nonpenetrating filtering surgery from January 1994 to December 2000. RESULTS: Both planar and nonplanar detachments were reported. Neither scrolls nor tears in Descemet's membrane were observed in any patient. After viscocanalostomy (four patients), the detachment was generally noticed shortly after the procedure and the cornea maintained its clarity. After deep sclerectomy with a collagen implant (five patients), it developed weeks to months postoperatively with adjacent corneal edema. Four patients had descemetopexy. None required more than one procedure. However, at the last visit, two detachments persisted, although they had diminished in size: one after viscocanalostomy and conservative treatment, the other after descemetopexy after deep sclerectomy with a collagen implant. Otherwise, to date, no signs of significant corneal damage have been observed clinically or by specular microscopy and pachymetry. CONCLUSIONS: The diagnosis of Descemet membrane detachment can be easily overlooked or misdiagnosed. Clinical presentation, clinical course, and pathogenesis depend on the type of nonpenetrating filtering surgery performed. Ophthalmologists should be aware of this unusual complication, which is likely to be more common after nonpenetrating filtering surgery than after trabeculectomy. A period of observation before attempting descemetopexy is recommended.
Dr. E. Ravinet, Hôpital Jules Gonin, Avenue de France 15 1004 Lausanne, Switzerland. andre.mermoud@ophtal.vd.ch
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
