Descemet's Membrane Detachment Management Following Trabeculectomy.

Area of Science:

• Ophthalmology
• Surgical Case Reports

Background:

• Trabeculectomy is a common glaucoma surgery.
• Descemet's membrane detachment (DMD) is a rare complication following ocular surgery, including trabeculectomy.

Observation:

• A 68-year-old woman developed significant DMD and corneal edema post-trabeculectomy.
• Initial management with intracameral air injection was unsuccessful.
• Recurrent choroidal effusions complicated the case, leading to DM contact with the lens.

Findings:

• Multiple surgical interventions were required, including choroidal taps and intracameral injections.
• A third surgery involving transconjunctival scleral flap closure, choroidal tap, and sulfur hexafluoride injection successfully reattached the DM.
• Subsequent bleb revision maintained ocular function, though cataract progression necessitated lens replacement.

Implications:

• Transconjunctival scleral flap closure can create a closed system to manage DMD after trabeculectomy.
• Surgical drainage of choroidal effusions is crucial for increasing anterior chamber depth and promoting DM reattachment.
• This case highlights a complex management strategy for a challenging post-operative complication.