Maurizio Gismondi1, Paolo Brusini. 1. Department of Ophthalmology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy.
Abstract
PURPOSE: To report a case of an intracorneal hematoma after canaloplasty. METHODS: Interventional case report of a surgical method used to resolve an intracorneal hematoma complication after canaloplasty. RESULTS: A 45-year-old man with uncontrolled pigmentary open-angle glaucoma underwent canaloplasty for glaucoma in the left eye. The patient previously underwent radial keratotomy for myopia in the same eye in 1997. Visual acuity was 20/20 without corrective lenses; intraocular pressure was 25 mm Hg with maximal medical therapy. During the surgical procedure, the canaloplasty microcatheter encountered an obstacle at the 6-o'clock position. During catheterization, a high-weight viscoelastic substance is normally injected in the canal. This probably caused a limited detachment of the Descemet membrane. On the day after surgery, slit-lamp biomicroscopy showed a large intracorneal hematoma that threatened the visual axis. A partial-thickness paracentesis was then performed on day 2 to remove the hematoma. CONCLUSIONS: Intracorneal hematoma is a rare complication of canaloplasty for glaucoma. The blood can be removed without interrupting the Descemet membrane by partial-thickness paracentesis.
PURPOSE: To report a case of an intracorneal hematoma after canaloplasty. METHODS: Interventional case report of a surgical method used to resolve an intracorneal hematoma complication after canaloplasty. RESULTS: A 45-year-old man with uncontrolled pigmentary open-angle glaucoma underwent canaloplasty for glaucoma in the left eye. The patient previously underwent radial keratotomy for myopia in the same eye in 1997. Visual acuity was 20/20 without corrective lenses; intraocular pressure was 25 mm Hg with maximal medical therapy. During the surgical procedure, the canaloplasty microcatheter encountered an obstacle at the 6-o'clock position. During catheterization, a high-weight viscoelastic substance is normally injected in the canal. This probably caused a limited detachment of the Descemet membrane. On the day after surgery, slit-lamp biomicroscopy showed a large intracorneal hematoma that threatened the visual axis. A partial-thickness paracentesis was then performed on day 2 to remove the hematoma. CONCLUSIONS: Intracorneal hematoma is a rare complication of canaloplasty for glaucoma. The blood can be removed without interrupting the Descemet membrane by partial-thickness paracentesis.
Authors: Juan Carlos Izquierdo Villavicencio; Josefina A Mejías Smith; Laura A Cañola Ramírez; Natalia Agudelo Arbelaez; Bárbara Rubio Lastra Journal: Case Rep Ophthalmol Med Date: 2019-04-21