[Hemorrhagic Descemet's membrane detachment after viscocanalostomy]

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Corneal Surgery

Background:

• Viscocanalostomy is a non-penetrating glaucoma surgery promoting aqueous humor outflow via Schlemm's canal.
• This technique aims to prevent complications associated with traditional filtering blebs.
• Descemet's membrane detachment (DMD) is a rare complication following such procedures.

Observation:

• A 64-year-old female developed hemorrhagic Descemet's membrane detachment (DMD) post-viscocanalostomy.
• Initial conservative management ('wait and see') for 15 days showed no improvement.
• Corneal edema and decreased vision were noted, indicating a need for intervention.

Findings:

• Surgical reapplication was performed using Descemet's membrane micropuncture and SF6 gas injection.
• The procedure involved injecting 20% SF6 gas into the anterior chamber.
• This intervention led to successful anatomical and functional recovery.

Implications:

• High-pressure injection of viscoelastic substances may contribute to DMD during viscocanalostomy.
• Management of hemorrhagic DMD depends on its characteristics and progression.
• Endothelial micropuncture with SF6 gas injection offers a viable treatment for post-viscocanalostomy DMD.