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Novel Treatment for Hemorrhagic Descemet Detachment After Canaloplasty
Mohammad Hamid1, Paul Thompson, Paul Harasymowycz
1Department of Ophthalmology, University of Montreal, Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada.
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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