Descemet membranotomy to treat pre-Descemet haematoma after deep sclerectomy and anterior segment-OCT related findings: A presentation of two clinical cases

Abstract

Case presentation

An 81 year-old woman and a 63 year-old man developed a pre-Descemet haematoma after deep sclerectomy (DS), the former during the surgery itself and the latter during the early post-operative period. The surgical technique is described that led to the evacuation of the haematoma and the preservation of the integrity of trabeculo-Descemet membrane. The anterior-segment OCT findings after surgery are also presented.

Conclusions

These are the first reported cases of pre-Descemet haematoma after DS that have been successfully repaired by an ab interno Descemet membranotomy. Surgeons should be aware of this rare, but potentially sight-threatening, complication.

Resumen

Casos clínicos

Mujer de 81 años y varón de 63, que desarrollan un hematoma pre-descemético (HPD) tras una esclerectomía profunda no perforante (EPNP), la primera durante la cirugía y el segundo durante el postoperatorio precoz. Se describe la técnica quirúrgica que permite tanto la evacuación del hematoma como la preservación de la integridad de la membrana trabéculo-descemética. Se presentan los hallazgos de OCT de segmento anterior tras la cirugía.

Discusión

Describimos los primeros casos del HPD tras EPNP, manejados exitosamente con una membranotomía ab interno de Descemet. Se debe estar alerta ante esta rara complicación, potencialmente amenazadora para la visión.