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Abstract #91136 Published in IGR 21-4
Hemorrhagic Descemet's Membrane Detachment in Non-penetrating Glaucoma Surgery: A Rare and Relevant Complication
Djavanmardi S; Arciniegas-Perasso CA; Duch S; Avila E; Milla EJournal of Glaucoma 2021; 30: e352-e356
PURPOSE: To describe five representative cases of hemorrhagic Descemet's membrane detachment in glaucoma surgery that had different origins, mechanisms and treatments. METHODS: Clinical records of patients that had undergone a non-penetrating glaucoma surgery, with a diagnosis of hemorrhagic Descemet's membrane detachment were reviewed for demographic data, clinical findings and treatment applied. RESULTS: Five patients with hemorrhagic Descemet's membrane detachment were included in this case series. They all had different causes, namely a massive hemorrhage at the end of a canaloplasty procedure, a needling maneuver, autologous blood injection, Swan syndrome and frequent eye rubbing. Hematoma evacuation was performed in four eyes, one of them from under the scleral flap of the deep sclerectomy and three of them through a surgical or laser perforation in Descemet's membrane. Air tamponade was done in most of these cases. One of these cases required transcorneal suture fixation. One case was observed expectantly. All cases successfully recovered but peripheral corneal stain was persistent in two cases. CONCLUSION: Hemorrhagic Descemet's membrane detachment is a rare but potential vision-threatening complication in glaucoma surgery. Different mechanisms may cause the bleeding and there are several techniques available to approach this complication. Pre-Descemet hematoma should be drained to avoid permanent corneal stain and air/gas tamponade may help to prevent recurrences.
Glaucoma Unit. Innova Ocular ICO Barcelona, Barcelona Spain.
Full articleClassification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
