New York Eye and Ear Infirmary, New York, New York 10003, USA.
J Cataract Refract Surg. 2010 Mar;36(3):508-11. doi: 10.1016/j.jcrs.2009.08.039.
We report a case of bilateral Descemet membrane detachment (DMD) after canaloplasty in a 70-year-old Portuguese man with primary open-angle glaucoma. The patient developed bilateral DMD immediately following consecutive (1 week apart) canaloplasty surgery in both eyes. Slitlamp biomicroscopy, gonioscopy, and Fourier-domain optical coherence tomography (FD-OCT) findings are described. On postoperative day 1, in both cases, slitlamp biomicroscopy revealed an unscrolled inferonasal DMD and a clear cornea with deep and quiet anterior chambers. Gonioscopy showed an intact, lightly pigmented, and distended trabecular meshwork with no evidence of suture extrusion. High-resolution FD-OCT revealed a widely dilated canal of Schlemm, trabecular distention, and a retrocorneal hyperreflective membrane corresponding to a DMD. At 3 months, the DMD resolved spontaneously in both eyes. Although DMD is a known complication of canaloplasty, the occurrence of bilateral symmetrically located DMDs in our case suggests a possible anatomical predisposition in addition to factors induced by the surgical technique.
我们报告了一例 70 岁葡萄牙男性原发性开角型青光眼患者行房角成形术后双侧后弹力层脱离（DMD）的病例。该患者在双眼先后（间隔 1 周）行房角成形术后立即出现双侧 DMD。描述了裂隙灯生物显微镜、房角镜和傅里叶域光学相干断层扫描（FD-OCT）的发现。术后第 1 天，在两种情况下，裂隙灯生物显微镜均显示未展开的鼻下方 DMD 和透明角膜，前房深且安静。房角镜显示完整、轻度色素沉着且扩张的小梁网，无缝线挤出的证据。高分辨率 FD-OCT 显示广泛扩张的 Schlemm 管、小梁扩张和后角膜高反射膜，对应于 DMD。3 个月时，双眼的 DMD 自发消退。尽管 DMD 是房角成形术的已知并发症，但我们的病例中双侧对称位置的 DMD 的发生除了手术技术诱导的因素外，还提示可能存在解剖学倾向。
