Novel Treatment for Hemorrhagic Descemet Detachment After Canaloplasty

Cornea. 2015 Dec;34(12):1611-2. doi: 10.1097/ICO.0000000000000636.

Abstract

Purpose: To describe a case of hemorrhagic Descemet membrane detachment after canaloplasty and to discuss its management using alteplase, a tissue plasminogen activator (TPA).

Methods: Interventional case report.

Results: A 60-year-old woman with advanced pseudoexfoliation glaucoma developed severe hemorrhagic Descemet detachment after canaloplasty. Initial anterior chamber and pre-Descemet washout yielded no improvement. On the fifth postoperative day, the patient received a novel pre-Descemet treatment using a TPA with an anterior chamber air bubble. The intracorneal blood clot quickly dissolved intraoperatively with the Descemet membrane almost completely reattached on postoperative day 1.

Conclusions: Hemorrhagic Descemet detachment is a rare and serious complication of canaloplasty. The use of pre-Descemet TPA dissolves the intracorneal blood clot and helps reattach Descemet membrane, allowing quick rehabilitation of patient's vision and preserving integrity of the cornea.

Publication types

  • Case Reports

MeSH terms

  • Corneal Diseases / drug therapy*
  • Corneal Diseases / etiology
  • Descemet Membrane / injuries*
  • Exfoliation Syndrome / surgery
  • Eye Hemorrhage / drug therapy*
  • Eye Hemorrhage / etiology
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Filtering Surgery / adverse effects*
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Middle Aged
  • Rupture
  • Tissue Plasminogen Activator / therapeutic use*

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator