Anterior Segment Optical Coherence Tomography–Guided Management Algorithm for Descemet Membrane Detachment After Intraocular Surgery

Sharma, Namrata; Gupta, Sandeep; Maharana, Prafulla K.; Prakash, S.; Nagpal, Ritu; Vajpayee, Rasik B

doi:10.1097/ico.0000000000000514

Cited by 29 publications

(24 citation statements)

References 23 publications

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“…DMD can be detected on slit-lamp biomicroscopy in cases with clear cornea however, in cases with severe corneal edema, anterior segment optical coherence tomography (ASOCT) remains the best imaging tool to conclusively diagnose its occurrence. [ 15 16 ] Various classification systems have been proposed for DMD such as planar (separation between the stroma and DM is <1 mm) versus nonplanar (>1 mm), scrolled versus nonscrolled, and peripheral versus peripheral with central involvement. DMDs that exhibit a rolled edge are described as scrolled, and those without a rolled edge are described as nonscrolled.…”

Section: Etiopathogenesismentioning

confidence: 99%

Corneal edema after phacoemulsification

Sharma

Singhal

Nair

et al. 2017

Indian J Ophthalmol

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Phacoemulsification is the most commonly performed cataract surgery in this era. With all the recent advances in investigations and management of cataract through phacoemulsification, most of the patients are able to achieve excellent visual outcome. Corneal edema after phacoemulsification in the immediate postoperative period often leads to patient dissatisfaction and worsening of outcome. Delayed onset corneal edema often warrants endothelial keratoplasty. This review highlights the etiopathogenesis, risk factors, and management of corneal edema in the acute phase including descemet's membrane detachment (DMD) and toxic anterior segment syndrome. Various investigative modalities such as pachymetry, specular microscopy, anterior segment optical coherence tomography, and confocal microscopy have been discussed briefly.

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Section: Etiopathogenesismentioning

confidence: 99%

Corneal edema after phacoemulsification

Sharma

Singhal

Nair

et al. 2017

Indian J Ophthalmol

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“…DMDs usually arise from tears at the incision site that progress to the central cornea as aqueous humor enters the predescemetic space, and shallowness of the anterior chamber has been considered a predisposing factor [ 15 ]. It is particularly important that surgeons are aware of this.…”

Section: Discussionmentioning

confidence: 99%

Descemet membrane detachment in femtosecond laser-assisted cataract surgery: a case report

2017

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AbstractsBackgroundFemtosecond laser-assisted cataract surgery (FLACS) has grown in popularity among ophthalmologists as a novel technique. However, descemet membrane detachment (DMD) began to be found as the complication after FLACS. We report a case of serious DMD following FLACS due to the inappropriate incision design.Case presentationAn 85-year-old man with apparent cornea arcus senilis underwent femtosecond laser-assisted cataract surgery in his right eye. A biplanar model was chosen for the main incision. A serious descemet membrane detachment (DMD) occurred at the end of phacoemulsification, which was connected with the main incision. However, the surgeon confused it with the transient swelling of corneal endothelium, and did not treated DMD timely. DMD was confirmed by anterior segment optical coherence tomography (AS-OCT) at the postoperative 1-month follow-up. Eventually DMD was resolved by intracameral perfluropropane (C3F8) gas injection.ConclusionsThis case suggests that a careful incision separation and a triplanar incision design in FLACS may reduce the incidence of DMD in cataract surgery.

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“…In eyes with extensive oedema that precludes clinical examination in detail, the areas and size of DMDs, corneal thickness and levels of scarring can be determined. 13…”

Section: Anterior Segment Optical Coherence Tomography (Asoct)mentioning

confidence: 99%

Corneal Oedema After Cataract Surgery- An Overview

Ranjan¹

2019

jemds

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BACKGROUND Phacoemulsification is the most commonly performed cataract surgery now a days. Most of the patients are able to achieve excellent visual outcome due to availability of advanced equipment. Corneal oedema after phacoemulsification in the immediate postoperative period often leads to patient dissatisfaction and worsening of outcome. Thorough pre-operative workup is important to find out any risk factor which is associated with high chances of postoperative corneal oedema. Aetiological factors of early onset corneal oedema must be identified and dealt accordingly. In the early stage, medical management or minor surgical interventions are sufficient to resolve the condition. Delayed onset corneal oedema often requires endothelial keratoplasty. This review highlights the etiopathogenesis, risk factors, investigative modalities and management of corneal oedema in the acute and late phase.

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Anterior Segment Optical Coherence Tomography–Guided Management Algorithm for Descemet Membrane Detachment After Intraocular Surgery

Abstract: ASOCT is a useful tool for timely diagnosis, characterization, and management of DMD in cases of nonresolving postoperative corneal edema. A new algorithm for intracameral injection of air or C3F8 in these cases helps to defer corneal transplantation.

Cited by 29 publications

References 23 publications

Corneal edema after phacoemulsification

Corneal edema after phacoemulsification

Descemet membrane detachment in femtosecond laser-assisted cataract surgery: a case report

Corneal Oedema After Cataract Surgery- An Overview

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