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Descemet’s Membrane Detachment during Phacocanaloplasty: Case Series and In-Depth Literature Review

This article presents three cases of Descemet’s membrane detachment (DMD) occurring during ‘ab externo’ phacocanaloplasty procedures in three patients with uncontrolled primary open-angle glaucoma (OAG) and discusses the management of this condition by reviewing the available literature. Following a...

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Autores principales: Orejudo de Rivas, Marta, Martínez Morales, Juana, Pardina Claver, Elena, Pérez García, Diana, Pérez Navarro, Itziar, Ascaso Puyuelo, Francisco J., Aramburu Clavería, Julia, Ibáñez Alperte, Juan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488042/
https://www.ncbi.nlm.nih.gov/pubmed/37685527
http://dx.doi.org/10.3390/jcm12175461
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author Orejudo de Rivas, Marta
Martínez Morales, Juana
Pardina Claver, Elena
Pérez García, Diana
Pérez Navarro, Itziar
Ascaso Puyuelo, Francisco J.
Aramburu Clavería, Julia
Ibáñez Alperte, Juan
author_facet Orejudo de Rivas, Marta
Martínez Morales, Juana
Pardina Claver, Elena
Pérez García, Diana
Pérez Navarro, Itziar
Ascaso Puyuelo, Francisco J.
Aramburu Clavería, Julia
Ibáñez Alperte, Juan
author_sort Orejudo de Rivas, Marta
collection PubMed
description This article presents three cases of Descemet’s membrane detachment (DMD) occurring during ‘ab externo’ phacocanaloplasty procedures in three patients with uncontrolled primary open-angle glaucoma (OAG) and discusses the management of this condition by reviewing the available literature. Following a successful 360° cannulation of Schlemm’s canal (SC), the microcatheter was withdrawn while an ophthalmic viscosurgical device (OVD) was injected into the canal. During passage through the inferonasal quadrant, a spontaneous separation of the posterior layer of the cornea was observed. Each case was managed differently after diagnosis, with the third case being drained intraoperatively based on experience gained from the previous cases. On the first postoperative day, slit-lamp biomicroscopy (BMC) revealed multiple DMDs in case one and a hyphema in the lower third of a deep anterior chamber. In the other two cases, a single DMD was observed. The second case developed hemorrhagic Descemet membrane detachment (HDMD), while the other two were non-hemorrhagic. In all three cases, anterior segment optical coherence tomography (AS-OCT) revealed the presence of retrocorneal hyperreflective membranes indicative of DMDs. These membranes were located in the periphery of the cornea and did not impact the visual axis. After evaluation, a small incision was made in the inferotemporal DMD of the first case. However, for the two remaining cases, a strategy of watchful waiting was deemed appropriate due to the location and size of the DMDs, as they did not affect the best-corrected visual acuity (BCVA). Over time, the patients demonstrated progressive improvement with a gradual reduction in the size of the DMDs.
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spelling pubmed-104880422023-09-09 Descemet’s Membrane Detachment during Phacocanaloplasty: Case Series and In-Depth Literature Review Orejudo de Rivas, Marta Martínez Morales, Juana Pardina Claver, Elena Pérez García, Diana Pérez Navarro, Itziar Ascaso Puyuelo, Francisco J. Aramburu Clavería, Julia Ibáñez Alperte, Juan J Clin Med Case Report This article presents three cases of Descemet’s membrane detachment (DMD) occurring during ‘ab externo’ phacocanaloplasty procedures in three patients with uncontrolled primary open-angle glaucoma (OAG) and discusses the management of this condition by reviewing the available literature. Following a successful 360° cannulation of Schlemm’s canal (SC), the microcatheter was withdrawn while an ophthalmic viscosurgical device (OVD) was injected into the canal. During passage through the inferonasal quadrant, a spontaneous separation of the posterior layer of the cornea was observed. Each case was managed differently after diagnosis, with the third case being drained intraoperatively based on experience gained from the previous cases. On the first postoperative day, slit-lamp biomicroscopy (BMC) revealed multiple DMDs in case one and a hyphema in the lower third of a deep anterior chamber. In the other two cases, a single DMD was observed. The second case developed hemorrhagic Descemet membrane detachment (HDMD), while the other two were non-hemorrhagic. In all three cases, anterior segment optical coherence tomography (AS-OCT) revealed the presence of retrocorneal hyperreflective membranes indicative of DMDs. These membranes were located in the periphery of the cornea and did not impact the visual axis. After evaluation, a small incision was made in the inferotemporal DMD of the first case. However, for the two remaining cases, a strategy of watchful waiting was deemed appropriate due to the location and size of the DMDs, as they did not affect the best-corrected visual acuity (BCVA). Over time, the patients demonstrated progressive improvement with a gradual reduction in the size of the DMDs. MDPI 2023-08-23 /pmc/articles/PMC10488042/ /pubmed/37685527 http://dx.doi.org/10.3390/jcm12175461 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Orejudo de Rivas, Marta
Martínez Morales, Juana
Pardina Claver, Elena
Pérez García, Diana
Pérez Navarro, Itziar
Ascaso Puyuelo, Francisco J.
Aramburu Clavería, Julia
Ibáñez Alperte, Juan
Descemet’s Membrane Detachment during Phacocanaloplasty: Case Series and In-Depth Literature Review
title Descemet’s Membrane Detachment during Phacocanaloplasty: Case Series and In-Depth Literature Review
title_full Descemet’s Membrane Detachment during Phacocanaloplasty: Case Series and In-Depth Literature Review
title_fullStr Descemet’s Membrane Detachment during Phacocanaloplasty: Case Series and In-Depth Literature Review
title_full_unstemmed Descemet’s Membrane Detachment during Phacocanaloplasty: Case Series and In-Depth Literature Review
title_short Descemet’s Membrane Detachment during Phacocanaloplasty: Case Series and In-Depth Literature Review
title_sort descemet’s membrane detachment during phacocanaloplasty: case series and in-depth literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488042/
https://www.ncbi.nlm.nih.gov/pubmed/37685527
http://dx.doi.org/10.3390/jcm12175461
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