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2016 ; 11
(3
): 323-5
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Descemet s Membrane Detachment Management Following Trabeculectomy
#MMPMID27621793
Sharifipour F
; Nassiri S
; Idan A
J Ophthalmic Vis Res
2016[Jul]; 11
(3
): 323-5
PMID27621793
show ga
PURPOSE: To present a case of total Descemet's membrane detachment (DMD) after
trabeculectomy and its surgical management. CASE REPORT: A 68-year-old woman
presented with large DMD and corneal edema one day after trabeculectomy.
Intracameral air injection on day 3 was not effective. Choroidal effusion
complicated the clinical picture with Descemet's membrane (DM) touching the lens.
Choroidal tap with air injection on day 6 resulted in DM attachment and totally
clear cornea on the next day. However, on day 12 the same scenario was repeated
with choroidal effusion, shallow anterior chamber (AC), and DM touching the lens.
The third surgery included transconjunctival closure of the scleral flap with
10/0 nylon sutures, choroidal tap, and intracameral injection of 20% sulfur
hexafluoride. After the third surgery, DM remained attached with clear cornea.
Suture removal and needling bleb revision preserved bleb function. Lens opacity
progressed, and the patient underwent uneventful cataract surgery 4 months later.
CONCLUSION: Scleral flap closure using transconjunctival sutures can be used for
DMD after trabeculectomy to make the eye a closed system. Surgical drainage of
choroidal effusions should be considered to increase the AC depth.