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A. G. Jaramillo, R. Ayyala MD, FRCS; Descemet Membrane Detachment Following Canaloplasty: Incidence and Management. Invest. Ophthalmol. Vis. Sci. 2009;50(13):460.
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To report the incidence and management of Descemet membrane detachment following Canaloplasty.
Retrospective review of all patients who underwent canaloplasty at Tulane University Hospital was performed. Canaloplasty reduces the intraocular pressure by viscodilation of the Schelmm’s canal. Descemet membrane detachment is a rare but potentially serious complication of canaloplasty. Patients with Descemet membrane detachment were identified.
The incidence of Descemet membrane detachment was 6% (4/67 patients). All patients developed the detachment during viscodilation of the Schelmm’s canal with healon GV. Two patients had blood mixed with healon in the detachment space. Two patients had large inferior detachments that stopped short of the visual axis. These were drained with a stab incision at the slit lamp at 2 weeks after the surgery. The remaining two patients had smaller detachments that resolved with out any intervention over 8 weeks. Descemet membrane detachment did not affect the vision and IOP in any patient.
Descemet membrane detachment with or without intracorneal hemorrhage is a rare complication of Canaloplasty. It is related to excessive amounts of Healon GV injection into the Schlemm’s canal during the viscodilation portion o the surgery. Depending up on the size of the detachment, it can be drained with a stab incision or observed. It is not associated with any vision threatening complications.
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