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Background: To report a case of extensive Descemet membrane detachment treated with repeated air Descemetopexies and venting incisions.
Results: A 69-year-old diabetic and hypertensive man with medically uncontrolled mixed POAG and pseudophakic glaucoma underwent left eye Ahmed valve implantation. Although the implantation was uneventful, the eye had a shallow anterior chamber (AC) with iridocorneal touch on the first post-operative day, due to overfiltration. We performed AC reformation using Healon GV on the same day. The following day, an extensive Descemet membrane detachment was seen, confirmed by anterior segment optical coherence
tomography (AS-OCT). With non-resolution after 1 week, and worsening of vision to hand movement perception, we performed Descemetopexy and AC reformation with Healon GV on day 8 after the initial surgery. On day 16, visual acuity was 6/24 although there was still partial detachment of the Descemet membrane. We repeated Descemetopexy with venting incisions. The detachment completely resolved after 20 days. About 2 months later, visual acuity was 6/24 with mild interface scarring. IOP was well controlled.
Conclusion: Early and repeated Descemetopexy in extensive Descemet membrane detachment can lead to reattachment and return of useful vision.
Conflicts of interest: The authors report no conflicts of interest.
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2.Li YH, Shi JM, Fan F, Duan XC, Jia SB. Descemet membrane detachment after trabeculectomy. Int J Ophthalmol 2012;5(4):527-9.
3.Marcon AS, Rapuano CJ, Jones MR, Laibson PR, Cohen EJ. Descemet’s membrane detachment after cataract surgery: management and outcome. Ophthalmology 2002;109(12):2325-30.
4.Riva I, Roberti G, Oddone F, Konstas AG, Quaranta L. Ahmed glaucoma valve implant: surgical technique and complications. Clin Ophthalmol. 2017;11:357-67.
5.Pansegrau ML, Mengarelli E, Dersu II. Complication of an Ahmed glaucoma valve implant: tube exposure with methicillinresistant Staphylococcus aureus infection. Digit J Ophthalmol. 2015;21(4):1-9
6.Rasouli M, Mather R, Tingey D. Descemet membrane detachment following viscoelastic injection for posttrabeculectomy hypotony Can J Ophthalmol. 2008; 43(2):254-5.
7.Kothari S, Kothari K, Parikh RS. Role of anterior segment optical coherence tomogram in Descemet’s membrane detachment. Indian Journal of Ophthalmology. 2011;59(4):303-5.
8.Martin FJ. Chemical and physical properties of Healon®. Australian Journal of Opthalmology.1983;11:8–9.
9.Harooni M, Freilich JM, Abelson M, Refojo M. Efficacy of hyaluronidase in reducing increases in intraocular pressure related to the use of viscoelastic substances. Archives of Ophthalmology. 1998;116(9):1218-21.