Hemorrhagic Descemet Membrane Detachment during Ab Interno Canaloplasty

To describe a Descemet membrane detachment in peripheral cornea after canaloplasty with ab interno approach in glaucoma.

A 60-year-old male with uncontrolled primary open-angle glaucoma (POAG) underwent ab interno canaloplasty in the left eye. The previous corrected visual acuity was 20/400 and intraocular pressure 26 mmHg with maximum medical therapy. There was evidence of minor intrastromal bleeding and limited Descemet membrane detachment during the introduction of intracanalicular viscoelastic. Speculate that the Descemet detachment occurred owing to the excessive pressure while injecting the viscoelastic. A conservative management was decided due to the size of the detachment outside the visual axis. On the first postsurgical day, the slit lamp biomicroscopy confirmed that the paralimbal extension of the pre-Descemet hemorrhage was 3mm and the radial extension was 2mm. Moreover the initial thickness of the pre-Descemet hemorrhage measurement with anterior segment OCT was 0.6mm. The follow-up was done weekly. At 3 months postoperatively, cornea recovered its transparency and morphology and intraocular pressure was 18mmHg with maximum medical therapy.

Descemet membrane detachment by viscoelastic with partial intrastromal hematoma is a rare complication of the ab interno canaloplasty, which can be managed conservatively if it has not compromised the visual axis and has a limited extension.