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Updated: Apr 30, 2026
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Published on: September 17, 2014
Hemorrhagic descemet membrane detachment after classic canaloplasty
L M Brandao1, S Orgul1, M C Grieshaber1
1Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman: Josef Flammer).
Purpose:
Canaloplasty is a safe and effective alternative in glaucoma surgery, avoiding the risk for hypotony and bleb-related complications. Two cases of hemorrhagic Descemet membrane detachment (DMD) after canaloplasty are reported in patients who did not have previous surgery.
Results:
Two patients with primary open-angle glaucoma underwent canaloplasty because of medically uncontrolled intraocular pressure (IOP). Canaloplasty was performed using a flexible microcatheter, viscoelastic material and a tensioning suture. The day after surgery, hemorrhagic DMD was observed in the inferior quadrants in both patients on slit-lamp biomicroscopy.
Therapy:
For the size and location (occlusion of the visual axis), aspiration of blood and descemetopexy with air tamponade were performed promptly. In both cases, a small translucent scar remained.
Conclusions:
Circumferential cannulation and viscodilation of the Schlemm canal increases the risk for DMD, which may be aggravated by blood reflux resulting from the tensioning suture and low postoperative IOP. Surgeons should be aware of this specific and potentially sight-threatening complication in classic canaloplasty. Immediate intervention is recommended for good visual prognosis.
