Department of Ophthalmology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Québec, Canada.
Cornea. 2013 May;32(5):712-3. doi: 10.1097/ICO.0b013e318281af48.
To describe a case of hemorrhagic Descemet membrane detachment following canaloplasty and to discuss its management using neodymium:yttrium-aluminum-garnet (Nd:YAG) laser Descemet membranotomy.
Interventional case report.
A 71-year-old woman with chronic open-angle glaucoma developed a hemorrhagic Descemet detachment after combined phacoemulsification, intraocular lens insertion, and canaloplasty. The hematoma did not improve with initial expectant management. Two and a half weeks after surgery, the Nd:YAG laser was applied to create a break in the Descemet membrane in the region of the hematoma. The intracorneal blood quickly dissipated into the anterior chamber. Visual acuity improved to 20/20. The endothelial cell count was 2342 cells per square millimeter 4 years after the surgery. Pachymetry did not show any long-term alterations as a result of the Nd:YAG treatment.
Hemorrhagic Descemet detachment is an uncommon complication after canaloplasty. Nd:YAG Descemet membranotomy is a successful means of clearing the hematoma and thus can prevent further complications, such as corneal blood staining.
描述一例青光眼术后行房水引流物植入术后并发出血性后弹力层脱离的病例，并探讨使用钕：钇铝石榴石（Nd：YAG）激光行后弹力层切开术治疗该并发症的方法。
介入性病例报告。
一名 71 岁女性，患有慢性开角型青光眼，在接受白内障超声乳化吸除术、人工晶状体植入和房水引流物植入术后发生了出血性后弹力层脱离。最初采用期待治疗，血肿并未改善。术后 2 周半，Nd：YAG 激光被应用于血肿区域的后弹力层膜上，以制造一个裂孔。角膜内的血液迅速消散到前房。视力提高到 20/20。术后 4 年，内皮细胞计数为 2342 个/平方毫米。角膜厚度计检查未显示 Nd：YAG 治疗导致任何长期改变。
出血性后弹力层脱离是房水引流物植入术后一种罕见的并发症。Nd：YAG 后弹力层切开术是清除血肿的有效方法，可以防止进一步的并发症，如角膜血染。
