A 64-year-old woman diagnosed with chronic open-angle glaucoma whose left eye was operated by viscocanalostomy.
The best corrected visual acuity was 0.7 and 0.8 in the right eye (OD) and left eye (LE) respectively.
Preoperative intraocular pressure (IOP) in the left eye was 26 mmHg despite treatment with the combination of thymolol maleate and dorzolamide twice daily with latanoprost once daily.
In the RE, with the same regimen, IOP was 17 mmHg.
Both in the study of the optic papillae and in the follow-up of the visual field, a progressive deterioration in the left eye was found.
It was decided to perform a viscocanalostomy according to the usual technique of Stegmann1.
We performed conjunctival dissection based on fornix and after dissecting a scleral flap that overcame the viscous scheling line, carefully locate a second deeper scleral canal, which was removed from the inner scleral line.
Finally, we decided to suture the superficial scleral flap with 10-0 nylon.
Twenty-four hours after surgery, the patient presented Descemet's membrane detachment (DMD) in the lower temporal quadrant of 5.0 x 5.0 mm. The space between the corneal stromal filled with Discemet
The visual acuity (VA) was at this time 0.5 and its IOP 16 mmHg.
Topical midazolam (MED) and topical steroids (dexamethasone) were prescribed and serial controls were carried out by controlling the intraocular pressure, taking biomycosis of the iliac vein (AV) and taking medication.
1.
Two weeks after the procedure, the patient underwent poorly informed corneal arching. In addition, a moderate corneal edema was observed, which caused a decrease in VA to 0.05, so it was decided to perform a repeated surgical wound opening.
Subsequently, SF6 was injected to keep the corneal endothelium applied.
1.
One week after this procedure, the DMD was completely reapplied, with folds radiated from the affected area, but with total disappearance of corneal edema, and recovery of VA to 0.8.
His IOP without medication was 16 mmHg.
