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Abstract #6265 Published in IGR 2-2
Intracorneal inclusion of high-molecular-weight sodium hyaluronate following detachment of Descemet's membrane during viscocanalostomy
Luke C; Dietlein TS; Jacobi PC; Konen W; Krieglstein GKCornea 2000; 19: 556-557
PURPOSE: Viscocanalostomy in accordance with Stegmann's technique is a new surgical option in the treatment of glaucoma. There are few reports available describing the specific complications of viscocanalostomy. The authors report a case of intracorneal inclusion of high-molecular-weight sodium hyaluronate following viscocanalostomy. CASE REPORT: A 66-year-old man with uncontrolled primary open-angle glaucoma of his right eye and a history of argon laser trabeculoplasty underwent viscocanalostomy in accordance with Stegmann's technique. During the filling of Schlemm's canal, a limited lysis of Descemet's membrane advanced centrally in the clear cornea adjacent to the site of canalostomy, forming an intracorneal bubble of high-molecular-weight sodium hyaluronate. Postsurgical slit-lamp biomicroscopy showed an intracorneal clear bubble within the corneal periphery without evidence of adjacent corneal edema and with no contact between the corneal endothelium and the iris. Follow-up examinations determined that the appearance of the corneal inclusion was essentially unchanged, with only a slight tendency of resorption. No signs of corneal scarring or endothelial decompensation could be noted. CONCLUSIONS: To date, the authors cannot determine any significant corneal damage in conjunction with the described complication. However, it is difficult to predict the long-term clinical course of this patient. Corneal decompensation as a result of possible endothelial toxicity of high-molecular weight sodium hyaluronate as well as spontaneous absorption seems possible.
Dr. C. Luke, Zentrum fur Augenheilkunde, Universität Koln, Joseph-Stelzmann Strasse 9, D-50924 Cologne, Germany
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
