Izquierdo Villavicencio Juan Carlos, Mejías Smith Josefina A, Cañola Ramírez Laura A, Agudelo Arbelaez Natalia, Rubio Lastra Bárbara
Glaucoma Research Department, Instituto de Ojos Oftalmosalud, Lima, Peru.
Glaucoma Department, Instituto de Ojos Oftalmosalud, Lima, Peru.
Case Rep Ophthalmol Med. 2019 Apr 21;2019:3653954. doi: 10.1155/2019/3653954. eCollection 2019.
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.
描述青光眼内路小梁切开术后周边角膜的后弹力层脱离。
一名60岁男性，原发性开角型青光眼（POAG）控制不佳，左眼接受了内路小梁切开术。此前最佳矫正视力为20/400，最大药物治疗下眼压为26 mmHg。在眼内注入粘弹剂时，有轻微基质内出血和局限性后弹力层脱离的迹象。推测后弹力层脱离是由于注入粘弹剂时压力过大所致。鉴于脱离位于视轴外，决定采取保守治疗。术后第一天，裂隙灯显微镜检查证实后弹力层前出血的角膜缘延伸为3mm，径向延伸为2mm。此外，前段光学相干断层扫描（OCT）测量的后弹力层前出血初始厚度为0.6mm。每周进行随访。术后3个月，角膜恢复透明和形态，最大药物治疗下眼压为18 mmHg。
粘弹剂导致的后弹力层脱离伴部分基质内血肿是内路小梁切开术的一种罕见并发症，如果未累及视轴且范围有限，可采取保守治疗。
