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Hemorrhagic Descemet's Membrane Detachment After Gonioscopy-Assisted Transluminal Trabeculotomy
Gunsu Deniz Mirza1, Enver Mirza2
1Clinic of Ophthalmology, Beyhekim Training and Research Hospital, University of Health Sciences, Konya, Turkey.
Journal of Glaucoma
|February 10, 2025
Summary
Hemorrhagic Descemet membrane detachment (DMD) is a rare complication following Gonioscopy-Assisted Transluminal Trabeculotomy (GATT). This case highlights a successful management strategy involving air tamponade and delayed cataract extraction.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Corneal Surgery
Background:
- Pseudoexfoliation glaucoma presents a surgical challenge.
- Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) is an effective glaucoma surgery.
- Descemet membrane detachment (DMD) is a known complication in anterior segment surgery.
Purpose of the Study:
- To report a rare case of hemorrhagic Descemet membrane detachment (DMD).
- To describe the management of hemorrhagic DMD after GATT.
- To raise awareness of this complication among surgeons performing GATT.
Main Methods:
- A patient with pseudoexfoliation glaucoma underwent combined GATT and cataract extraction.
- Hemorrhagic DMD occurred due to blood reflux during GATT.
- The DMD was reattached with air tamponade; cataract extraction was postponed.
Main Results:
- The hemorrhagic DMD was monitored for 3 months without spontaneous resolution.
- Delayed cataract extraction involved a side port incision at the DMD site.
- The anterior chamber was irrigated, and an air bubble was instilled, leading to DM reattachment and hemorrhage resolution.
Conclusions:
- Hemorrhagic DMD is an uncommon complication post-GATT.
- Management can be challenging but successful with prompt intervention.
- Surgeons performing GATT must be vigilant for this rare corneal complication.
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