Descemet's Membrane Detachment during 360 degreesTrabeculotomy

Lee, Sang Hyup; Lee, Ji Eun

Abstract

We report Descemet's membrane detachment during 360 degrees trabeculotomy using 6-0 polypropylene suture fragment. Using 6-0 polypropylene suture fragment 360 degrees trabeculotomy was performed on a 24-year-old male patient with juvenile glaucoma showing iris inserting anteriorly. Soon after pulling the suture fragment, anterior chamber became shallow abruptly and massive bleeding developed into anterior chamber. Corneal edema and large blood clot in anterior chamber were noted postoperatively.Rolled Descemet's membrane was attached to superior cornea.Seven and 14 days after trabeculotomy, viscoelastic was injected into anterior chamber and flattened the rolled Descemet's membrane.At 25 days after trabeculotomy, Descemet's membrane was reattached to central cornea, which became clear. Extensive Descemet's membrane detachment during 360 degrees trabeculotomy can be prevented by cautious pulling of suture fragments and injection of viscoelastic into anterior chamber just before pulling.When detached Descemet's membrane was rolled too tightly to be reattached by conventional procedure such as mattress suture or gas injection, the reattachment of the Descemet's membrane can be achieved by unrolling the membrane using viscoelastic