Descemet’s membrane detachment after cataract extraction surgery

Abstract

Descemet's membrane detachment (DMD) is a rare but potentially serious complication of intraocular surgery, most commonly cataract extraction. Many predisposing factors of DMD have been postulated; however, none have proved to be significant. Most DMDs are surgically induced; however, the occurrence of this entity bilaterally, during or after otherwise uneventful cataract extraction surgery, might be related to an inherent abnormal adhesion between the stroma and Descemet's membrane or pre-existing endothelial abnormalities. Early recognition and proper management are important to preserve the vision and avoid permanent corneal damage. Although a small, localized detachment at the wound area tends to heal by spontaneous re-attachment, a larger or more progressive detachment requires surgical intervention because the prognosis of spontaneous re-attachment is poor.

Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery

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Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery

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Case Report: “Spontaneous Descemet Membrane Detachment”

“…Cases of spontaneous DMD occurred in patients with osteogenesis imperfecta [27,28], anterior megalophthalmos [29], DMD among siblings [30], and bilateral DMD in the same patient [13], which stressed the hypothesis of an anatomic predisposition.…”

“…Medical therapy includes topical steroids and topical saline solution four or more times daily. A mean period for spontaneous reattachment of DMD of 9.8 weeks has been reported [13], but Assia et al described spontaneous reattachment of DMD within 2-3 months [14].…”

Spontaneous resolution of recurrent Descemet's membrane detachment after trabeculectomy: A case report

“…In clinical practice, there are also many other causes for DMD, such as surgery, shallow anterior chamber, and corneal endothelial dysfunction. 1 For ophthalmic surgery, DMD has most frequently been observed after cataract surgery, but it has also been reported in many other ophthalmic surgeries, such as peripheral iridectomy, trabeculectomy, lamellar keratoplasty, penetrating keratoplasty, vitrectomy, and so on. 2 , 3 , 4 , 5 , 6 , 7 , 8 Corneal edema and opacity, double anterior chamber, decreased vision, and even corneal endothelial dysfunction may appear once DMD happens.…”

Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery

“……”

Case Report: “Spontaneous Descemet Membrane Detachment”

“…Cases of spontaneous DMD occurred in patients with osteogenesis imperfecta [27,28], anterior megalophthalmos [29], DMD among siblings [30], and bilateral DMD in the same patient [13], which stressed the hypothesis of an anatomic predisposition.…”

“…Medical therapy includes topical steroids and topical saline solution four or more times daily. A mean period for spontaneous reattachment of DMD of 9.8 weeks has been reported [13], but Assia et al described spontaneous reattachment of DMD within 2-3 months [14].…”

Spontaneous resolution of recurrent Descemet's membrane detachment after trabeculectomy: A case report

“…In clinical practice, there are also many other causes for DMD, such as surgery, shallow anterior chamber, and corneal endothelial dysfunction. 1 For ophthalmic surgery, DMD has most frequently been observed after cataract surgery, but it has also been reported in many other ophthalmic surgeries, such as peripheral iridectomy, trabeculectomy, lamellar keratoplasty, penetrating keratoplasty, vitrectomy, and so on. 2 , 3 , 4 , 5 , 6 , 7 , 8 Corneal edema and opacity, double anterior chamber, decreased vision, and even corneal endothelial dysfunction may appear once DMD happens.…”

Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery

“……”

Case Report: “Spontaneous Descemet Membrane Detachment”

“…Cases of spontaneous DMD occurred in patients with osteogenesis imperfecta [27,28], anterior megalophthalmos [29], DMD among siblings [30], and bilateral DMD in the same patient [13], which stressed the hypothesis of an anatomic predisposition.…”

“…Medical therapy includes topical steroids and topical saline solution four or more times daily. A mean period for spontaneous reattachment of DMD of 9.8 weeks has been reported [13], but Assia et al described spontaneous reattachment of DMD within 2-3 months [14].…”

Spontaneous resolution of recurrent Descemet's membrane detachment after trabeculectomy: A case report

“…In clinical practice, there are also many other causes for DMD, such as surgery, shallow anterior chamber, and corneal endothelial dysfunction. 1 For ophthalmic surgery, DMD has most frequently been observed after cataract surgery, but it has also been reported in many other ophthalmic surgeries, such as peripheral iridectomy, trabeculectomy, lamellar keratoplasty, penetrating keratoplasty, vitrectomy, and so on. 2 , 3 , 4 , 5 , 6 , 7 , 8 Corneal edema and opacity, double anterior chamber, decreased vision, and even corneal endothelial dysfunction may appear once DMD happens.…”