CorneaDecember 2015Case Reports

Novel Treatment for Hemorrhagic Descemet Detachment After Canaloplasty.

Glaucoma SurgeryEpidemiology & Genetics

Summary

Hemorrhagic Descemet detachment is a rare and serious complication of canaloplasty.

Abstract

PURPOSE

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.

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Discussion

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