A 64-year-old woman diagnosed with chronic open-angle glaucoma whose left eye was operated on by viscocanalostomy. Her best corrected visual acuity was 0.7 and 0.8 in the right eye (OD) and left eye (OI) respectively. Preoperative intraocular pressure (IOP) in the LA was 26 mmHg despite treatment with the combination of timolol maleate and dorzolamide twice daily together with latanoprost once daily. In the OD, with the same regimen, IOP was 17 mmHg. Both in the study of the optic papillae and in the follow-up of the visual field, a progressive deterioration was observed in the OI.
It was decided to perform a viscocanalostomy according to the usual Stegmann technique1. We performed the conjunctival dissection with a fornix base and after dissection of a scleral flap that went beyond Schwalbe's line, we created a second, deeper scleral flap, which was removed, where we proceeded to locate Schlemm's canal and carefully canalised it inwards by injecting the viscoelastic. Finally, we proceeded to suture the superficial scleral flap tightly with 10-0 nylon.
Twenty-four hours after surgery, the patient had a Descemet's membrane detachment (DMD) in the inferior temporal quadrant measuring 5.0 x 5.0 mm. The space between Descemet's membrane and the corneal stroma had significant haematic and viscoelastic filling. Visual acuity (VA) at this time was 0.5 and IOP 16 mmHg. Treatment was prescribed with mydriatics (cyclopentolate) and topical steroids (dexamethasone) and serial controls were carried out with VA control, biomicroscopy, gonioscopy and intraocular pressure measurement.

Two weeks after the operation, the state of the corneal inclusion remained practically unchanged, with moderate corneal oedema causing a decrease in VA to 0.05, so surgical reapplication was decided using the following technique: A myringotome was used to make an intentional break in the lower part of the descematic detachment and by repeated introduction of air and balanced saline into the anterior chamber, both the viscoelastic and the haematoma were drained through the surgical opening of the descematic detachment. Subsequently SF6 was injected to keep the corneal endothelium in place.

One week after this procedure the DMD was completely reapplied, with radiated folds from the affected area, but with complete disappearance of the corneal oedema, and recovery of VA to 0.8. His unmedicated IOP was 16 mmHg.