Department of Ophthalmology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy.
Cornea. 2011 Jun;30(6):718-9. doi: 10.1097/ICO.0b013e3182000955.
To report a case of an intracorneal hematoma after canaloplasty.
Interventional case report of a surgical method used to resolve an intracorneal hematoma complication after canaloplasty.
A 45-year-old man with uncontrolled pigmentary open-angle glaucoma underwent canaloplasty for glaucoma in the left eye. The patient previously underwent radial keratotomy for myopia in the same eye in 1997. Visual acuity was 20/20 without corrective lenses; intraocular pressure was 25 mm Hg with maximal medical therapy. During the surgical procedure, the canaloplasty microcatheter encountered an obstacle at the 6-o'clock position. During catheterization, a high-weight viscoelastic substance is normally injected in the canal. This probably caused a limited detachment of the Descemet membrane. On the day after surgery, slit-lamp biomicroscopy showed a large intracorneal hematoma that threatened the visual axis. A partial-thickness paracentesis was then performed on day 2 to remove the hematoma.
Intracorneal hematoma is a rare complication of canaloplasty for glaucoma. The blood can be removed without interrupting the Descemet membrane by partial-thickness paracentesis.
报告一例青光眼 canaloplasty 术后发生角膜内血肿。
对 canaloplasty 术后角膜内血肿并发症的一种手术方法进行介入性病例报告。
一名 45 岁男性患有未控制的色素性开角型青光眼，左眼行 canaloplasty 治疗青光眼。该患者曾于 1997 年在同一眼行放射状角膜切开术治疗近视。视力为 20/20 无需矫正；眼内压 25mmHg，经最大药物治疗。在手术过程中，canaloplasty 微导管在 6 点钟位置遇到障碍。在导管插入过程中，通常会在管内注射高比重的粘弹性物质。这可能导致了一定程度的后弹力层脱离。术后第一天裂隙灯生物显微镜检查显示大的角膜内血肿，威胁到视轴。第二天行部分厚度房穿刺术以清除血肿。
角膜内血肿是青光眼 canaloplasty 的罕见并发症。通过部分厚度房穿刺术可以在不中断后弹力层的情况下清除血液。
