Descemet Membrane Detachment Following Ab-interno Canaloplasty with 360-degree Gonioscopy-assisted Transluminal Trabeculotomy: A Case Report

We describe two cases of Descemet membrane detachment (DMD) as a complication of gonioscopy-assisted transluminal trabeculotomy (GATT). The two patients had a history of retinal vein occlusions, subsequent intravitreal anti-vascular endothelial growth factor injections and uncontrolled intraocular pressures. They underwent ab-interno canaloplasty with 360-degree GATT without any intraoperative complications. In each case, DMD was noted on post-operative day 1. Both detachments were observed for several weeks before reattachment occurred. These cases illustrate that DMD is a potential sight-threatening complication of GATT, although the exact mechanisms involved remain uncertain. We hypothesize that the DMD may occur during the viscodilation of the Schlemm canal or due to the cleavage plane being anterior to the trabecular meshwork.