Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 1;30(7):e352-e356.
doi: 10.1097/IJG.0000000000001721.

Hemorrhagic Descemet's Membrane Detachment in Nonpenetrating Glaucoma Surgery

Shirin Djavanmardi  1 , Carlos A Arciniegas-Perasso  1 , Susana Duch  1 , Elena Avila-Marrón  1 , Elena Milla  1   2
Affiliations

Hemorrhagic Descemet's Membrane Detachment in Nonpenetrating Glaucoma Surgery

Shirin Djavanmardi et al. J Glaucoma. .

Abstract

Purpose: To describe 5 representative cases of hemorrhagic Descemet's membrane (DM) detachment in glaucoma surgery that had different origins, mechanisms and treatments.

Methods: Clinical records of patients that had undergone a nonpenetrating glaucoma surgery, with a diagnosis of hemorrhagic DM detachment were reviewed for demographic data, clinical findings and treatment applied.

Results: Five patients with hemorrhagic DM detachment were included in this case series. They all had different causes, namely a massive hemorrhage at the end of a canaloplasty procedure, a needling maneuver, autologous blood injection, Swan syndrome, and frequent eye rubbing. Hematoma evacuation was performed in 4 eyes, 1 of them from under the scleral flap of the deep sclerectomy and 3 of them through a surgical or laser perforation in DM. Air tamponade was done in most of these cases. One of these cases required transcorneal suture fixation. One case was observed expectantly. All cases successfully recovered but peripheral corneal stain was persistent in 2 cases.

Conclusion: Hemorrhagic DM detachment is a rare but potential vision-threatening complication in glaucoma surgery. Different mechanisms may cause the bleeding and there are several techniques available to approach this complication. Pre-Descemet hematoma should be drained to avoid permanent corneal stain and air/gas tamponade may help to prevent recurrences.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

References

    1. Casas-Llera P, Arnalich-Montiel F, Muñoz-Negrete FJ, et al. Hematoma pre-descemético tras EPNP, tratado mediante membranotomía de la Descemet y hallazgos de OCT de segmento anterior: presentación de 2 casos clínicos [Descemet membranotomy to treat pre-descemet haematoma after deep sclerectomy and anterior segment-OCT related findings: a presentation of two clinical cases]. Arch Soc Esp Oftalmol. 2017;92:44–48.
    1. Kozobolis VP, Christodoulakis EV, Siganos CS, et al. Hemorrhagic Descemet’s membrane detachment as a complication of deep sclerectomy: a case report. J Glaucoma. 2001;10:497–500.
    1. Alobeidan SA, Almobarak FA. Incidence and management of haemorrhagic Descemet membrane detachment in canaloplasty and phacocanaloplasty. Acta Ophthalmol. 2016;94:e298–e304.
    1. Jaramillo A, Foreman J, Ayyala RS. Descemet membrane detachment after canaloplasty: incidence and management. J Glaucoma. 2014;23:351–354.
    1. Lewis RA, von Wolff K, Tetz M, et al. Canaloplasty: circumferential viscodilation and tensioning of Schlemmʼs canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults. J Cataract Refract Surg. 2007;33:1217–1226.