# Descemet’s Membrane Detachment Following Inadvertent Intrastromal Injection of an Ophthalmic Viscoelastic Device

## TL;DR

A patient developed a corneal complication after an incorrect injection during glaucoma surgery, which was later treated with air tamponade.

## Contribution

This case highlights an alternative treatment for Descemet’s membrane detachment caused by viscoelastic device misinjection.

## Key findings

- Inadvertent intrastromal injection of Healon5® caused Descemet’s membrane detachment.
- Intracameral air tamponade resolved the detachment more effectively than observation or surgical evacuation.
- Highly cohesive OVDs like Healon5® may benefit from air tamponade in similar cases.

## Abstract

Hypotony is a well-documented postoperative complication of glaucoma filtration surgery. Management may include the injection of an ophthalmic viscoelastic device (OVD) into the anterior chamber. This case report describes a 45-year-old woman with juvenile-onset open-angle glaucoma who developed clinical hypotony after trabeculectomy surgery augmented with mitomycin-C. An intracameral injection of Healon5® (Johnson & Johnson Vision, USA) was attempted to restore physiological intraocular pressure (IOP); however, Healon5® was inadvertently introduced into the corneal stroma, causing a localised Descemet’s membrane detachment (DMD). Following non-resolution with observation and attempted surgical evacuation, an intracameral air tamponade successfully addressed the DMD. An intracameral air tamponade may provide a quicker alternative to prolonged observation, particularly for highly cohesive OVDs such as Healon5®.