A case of Descemet&amp;rsquo;s membrane detachments and tears during phacoemulsification

Wang, Yong; Guan, Huaijin

doi:10.2147/tcrm.s87162

Cited by 10 publications

(5 citation statements)

References 17 publications

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“…The incidence of significant sight-threatening DMD after phacoemulsification was 0.044% to 0.52% [ 14 , 15 ]. Improper operation of instrument entry into the anterior chamber is the most significant cause of DMD following phacoemulsification [ 18 ]. Although postoperative visual acuity and corneal thickness returned to normal levels afterward, the corneal endothelial cell density decreased by 30% from preoperative density in our study.…”

Section: Discussionmentioning

confidence: 99%

A Simple Repair Algorithm for Descemet’s Membrane Detachment Performed at the Slit Lamp

Zhu

Fan

et al. 2022

JCM

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Our study aims to investigate a simple repair algorithm for Descemet’s membrane detachment (DMD) following phacoemulsification with Pentacam and anterior segment optical coherence tomography (AS-OCT). Twelve patients with DMD were included in this retrospective study. All cases had persistent corneal edema after phacoemulsification and no improved response to conservative treatment. The repair algorithm consisted of delineating the DMD with the Pentacam and AS-OCT, paracentesis, and intracameral air bubble performed at the slit lamp, followed by immediate supine position. At one month, the final status of Descemet’s membrane (DM), best-corrected visual acuity, and incidence of complications were noted. DMD was involved in the visual axis in all cases. The mean interval between phacoemulsification and repair was 5.3 ± 1.2 days. Complete reattachment of DM and corneal clarity occurred in all 12 eyes. Eleven (91.7%) eyes underwent one repair procedure, while one eye (8.3%) underwent a repeat procedure. No adverse events were found. Minor post-intervention complications included temporary increased intraocular pressure due to pupillary block in one eye (8.3%). In conclusion, our modified and simplified repair algorithm for DMD can be performed safely as an outpatient procedure, with accurate delineation using a Pentacam and AS-OCT. It may provide new insight into the timely diagnosis, evaluation, and management of DMD.

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Section: Discussionmentioning

confidence: 99%

A Simple Repair Algorithm for Descemet’s Membrane Detachment Performed at the Slit Lamp

Zhu

Fan

et al. 2022

JCM

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“…This was endorsed by the findings of Wang and colleagues who also indicated that the inappropriate hydration of corneal side ports might result in DMD. 7 We recommend being gentle and vigilant while hydrating side ports. Over hydration should be avoided.…”

Section: Discussionmentioning

confidence: 99%

Role of Anterior segment OCT in cases of Post Cataract Surgery Corneal Edema

Mahmood¹,

Jamil²,

Iqbal³

2022

pak J Ophthalmol

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Post cataract surgery corneal edema is a disturbing complication both for the patient and the surgeon. We present a case of post cataract surgery corneal edema.A 61 year old lady developed right corneal edema after an uneventful phacoemulsification. Initially diagnosis of surgery induced corneal endothelial decompensation was made. Anterior segment OCT was performed that revealed detached Descemet membrane. Intraocular SF6 gas injection successfully treated the case. Anterior segment OCT is a valuable tool in cases of post cataract surgery corneal edema to establish a diagnosis.

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“…Improper surgical manipulations including anteriorly placed, shelved, or small incisions, suboptimal quality of the surgical instruments (especially use of blunt microkeratomes), or engagement of the DM during irrigation/aspiration, and antibiotic, saline, or viscoelastic material injection into the space between the deep stroma and DM are primary reasons for intraoperative DMD. 1–6 Ti and colleagues 7 described several risk factors for post-operative DMD including older age, grade 4 or 5 nuclear sclerotic cataract, pre-existing endothelial disease, and corneal oedema on the first post-operative day. On the other hand, genetically related weak or abnormal adhesions between the stroma and DM also underlie anatomic predispositions for the development of intraoperative or postoperative DMD.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of clinically significant DMD associated with cataract surgery has been reported as 0.05 % to 0.5 %. 1 In these cases, DMD is mostly seen during surgery or in the early post-operative period associated with surgical technique, surgical equipment or genetic factors 1–4…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of late onset post-phacoemulsification Descemet’s membrane detachment

Altıntaş

İlhan²

2019

Ophthalmol Eye Dis

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Purpose: To present a case with the late-onset post-phacoemulsification Descemet’s membrane detachment that has been treated successfully. Methods: Case report. Results: A 68-year-old female patient presented with the complaint of decreased vision in her pseudophakic left eye after a 4-week silent post-phacoemulsification period. In the biomicroscopy, corneal oedema was seen to be prominent on the nasal incision side. Anterior segment optical coherence tomography objectively revealed the presence of Descemet’s membrane detachment. Treatment of descemetopexy was applied by injecting 0.3-mL perfluoropropane gas into the anterior chamber. No complication associated with descemetopexy was noticed during recovery. Total Descemet’s membrane detachment reattachment was achieved and perfluoropropane gas resorption from the anterior chamber was completed by the end of 1-month post-injection. The cornea was transparent and best corrected visual acuity increased to 20/20. Discussion: DMD is a rare complication following phacoemulsification and this patient had not any preoperative, intraoperative, or postoperative risk factors for DMD.It generally occurs in early-postoperative period and late-onset DMDs have been reported less frequently.The success rates with intracameral gas injections in similar cases have been reported to be 90% - 95%. Conclusion: To the best of our knowledge, this is one of the latest onset post-phacoemulsification Descemet’s membrane detachment cases in literature that has been treated successfully. The results of this case showed that descemetopexy is a safe and effective treatment method for late-onset post-phacoemulsification DMD.

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A case of Descemet’s membrane detachments and tears during phacoemulsification

Cited by 10 publications

References 17 publications

A Simple Repair Algorithm for Descemet’s Membrane Detachment Performed at the Slit Lamp

A Simple Repair Algorithm for Descemet’s Membrane Detachment Performed at the Slit Lamp

Role of Anterior segment OCT in cases of Post Cataract Surgery Corneal Edema

Successful treatment of late onset post-phacoemulsification Descemet’s membrane detachment

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