Inadvertent Descemet membrane detachment after intracameral injection of high-viscosity sodium hyaluronate

Abstract

A patient developed extensive Descemet membrane detachment after intracameral injection of a high-viscosity sodium hyaluronate ophthalmic viscosurgical device (OVD) (sodium hyaluronate 2.3% [Healon5]). The patient had developed anterior chamber shallowing after an Ex-Press shunt procedure. In an attempt to reform the anterior chamber, the OVD was administered intracamerally. However, during the procedure, a substantial amount of the material was injected accidentally just anterior to Descemet membrane. As a result, a large central Descemet membrane detachment was observed, accompanied by corneal endothelium contact with the anterior surface of the intraocular lens. Two attempts to surgically evacuate the OVD were only partially successful. Conservative management resulted in the return of visual acuity to baseline, complete absorption of the OVD, and total reattachment of Descemet membrane. These findings were confirmed by long-term follow-up using anterior segment optical coherence tomography.