Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt

Purpose: To describe a case in which Descemet's membrane interfered with aqueous humor drainage through an ExPRESS mini shunt. This problem was successfully solved by Nd:YAG laser membranotomy. Case Report: A 70-year-old male, diagnosed with corticosteroid-induced glaucoma in his right eye, pre...

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Main Authors: Rikiya Tamaki, Masahiro Zako
Format: Article
Language:English
Published: Karger Publishers 2014-10-01
Series:Case Reports in Ophthalmology
Subjects:
Online Access:http://www.karger.com/Article/FullText/368697
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author Rikiya Tamaki
Masahiro Zako
author_facet Rikiya Tamaki
Masahiro Zako
author_sort Rikiya Tamaki
collection DOAJ
description Purpose: To describe a case in which Descemet's membrane interfered with aqueous humor drainage through an ExPRESS mini shunt. This problem was successfully solved by Nd:YAG laser membranotomy. Case Report: A 70-year-old male, diagnosed with corticosteroid-induced glaucoma in his right eye, presented to our hospital. Topical betamethasone treatment was discontinued, and the patient was treated with intravenous D-mannitol and acetazolamide, followed by oral acetazolamide, oral potassium L-aspartate, topical dorzolamide hydrochloride, topical carteolol hydrochloride, and topical latanoprost. However, his right intraocular pressure (IOP) remained elevated. We performed ExPRESS shunt surgery in the patient's right eye. His postoperative IOP was initially within the normal range, but it reincreased 1 month after surgery. We found that the Descemet's membrane was interfering with both the primary (axial) and reserve orifices at the tip of the ExPRESS mini shunt. Nd:YAG laser membranotomy was performed and the patient's IOP again improved without any other medical treatment. Conclusion: Descemet's membrane interfered with aqueous humor drainage via ExPRESS mini shunt, causing an increased IOP, which was resolved by Nd:YAG laser membranotomy.
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spelling doaj.art-4394e90147f04a38a712a67f2e21b1732022-12-21T17:44:30ZengKarger PublishersCase Reports in Ophthalmology1663-26992014-10-015334334610.1159/000368697368697Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini ShuntRikiya TamakiMasahiro ZakoPurpose: To describe a case in which Descemet's membrane interfered with aqueous humor drainage through an ExPRESS mini shunt. This problem was successfully solved by Nd:YAG laser membranotomy. Case Report: A 70-year-old male, diagnosed with corticosteroid-induced glaucoma in his right eye, presented to our hospital. Topical betamethasone treatment was discontinued, and the patient was treated with intravenous D-mannitol and acetazolamide, followed by oral acetazolamide, oral potassium L-aspartate, topical dorzolamide hydrochloride, topical carteolol hydrochloride, and topical latanoprost. However, his right intraocular pressure (IOP) remained elevated. We performed ExPRESS shunt surgery in the patient's right eye. His postoperative IOP was initially within the normal range, but it reincreased 1 month after surgery. We found that the Descemet's membrane was interfering with both the primary (axial) and reserve orifices at the tip of the ExPRESS mini shunt. Nd:YAG laser membranotomy was performed and the patient's IOP again improved without any other medical treatment. Conclusion: Descemet's membrane interfered with aqueous humor drainage via ExPRESS mini shunt, causing an increased IOP, which was resolved by Nd:YAG laser membranotomy.http://www.karger.com/Article/FullText/368697Corticosteroid-induced glaucomaDescemet’s membraneExPRESS mini shunt
spellingShingle Rikiya Tamaki
Masahiro Zako
Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt
Case Reports in Ophthalmology
Corticosteroid-induced glaucoma
Descemet’s membrane
ExPRESS mini shunt
title Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt
title_full Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt
title_fullStr Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt
title_full_unstemmed Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt
title_short Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt
title_sort interference of descemet s membrane with aqueous humor drainage via an express mini shunt
topic Corticosteroid-induced glaucoma
Descemet’s membrane
ExPRESS mini shunt
url http://www.karger.com/Article/FullText/368697
work_keys_str_mv AT rikiyatamaki interferenceofdescemetsmembranewithaqueoushumordrainageviaanexpressminishunt
AT masahirozako interferenceofdescemetsmembranewithaqueoushumordrainageviaanexpressminishunt