Descemet′s membrane detachment caused by inadvertent vancomycin injection

Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Medhi, Jnanankar; Altaf, Abu

doi:10.4103/0301-4738.40368

Cited by 14 publications

(3 citation statements)

References 8 publications

(13 reference statements)

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“…DMD is an unusual complication of phacoemulsification surgery. In manual phacoemulsification surgery, the described surgical risk factors are three: first, incision-related, such as the use of dull blades [ 5 ], inappropriate incisions (oblique, excessively anterior, shelved incisions) [ 6 ], tight main incisions that do not fit the phaco probe [ 7 ]; second, instrument-related, such as the use of blunt instruments [ 8 ], inadvertent insertion of instruments between the corneal stroma and the Descemet membrane [ 9 ]; and, third, surgeon-related, such as engagement of the Descemet membrane during the irrigation/aspiration stage, unexpected injection of antibiotics, saline, or viscoelastic into the space between the deep stroma and the Descemet membrane [ 10 ], and surgeon inexperience [ 11 ]. After femtosecond laser was applied in cataract surgery, Ricardo first reported four localized DMD cases in FLACS that occurred because of an encapsulated bubble that did not spread into the anterior chamber (AC) and had formed when the incision was created [ 4 ].…”

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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Section: Discussionmentioning

confidence: 99%

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

2017

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“…Descemet's detachment can be instrument induced (scroll like) or due to injection of fluid (attached to stroma all around the detachment). [ 1 ] Descemet's membrane detachment can also be classified into planar type with the Descemet's membrane separation of less than 1 mm and non-planar type with a separation of greater than 1 mm. Planar detachments are more likely to resolve spontaneously, and non-planar detachments should be repaired early.…”

Section: Discussionmentioning

confidence: 99%

Descemet′s membrane detachment managed with perfluro-n-octane liquid

Kumar¹,

Vaithianathan²

2012

Indian J Ophthalmol

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“…The latter consisted of 0.1 mL of 0.5 mg/0.1 mL moxifloxacin and 0.06 mL of 1 mg/0.1 mL cefuroxime and was injected in a circular pattern surrounding the lesion. The main goals of the case and the approaches used to deliver the treatment were to avoid a Descemet's membrane separation from the considerable stromal edema by delivering the least amount of antibiotics possible, and by positioning the needle tracks outside of the visual axis [13,29].…”

Section: Bacterial Keratitismentioning

confidence: 99%

Intrastromal Injections in the Management of Infectious Keratitis

Zemba

Radu²,

Istrate

et al. 2023

Pharmaceutics

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Infectious keratitis is a major global cause of vision loss and blindness. Prompt diagnosis and targeted antibiotic treatment are crucial for managing the condition. Topical antimicrobials are the most effective therapy for bacterial keratitis, but they can lead to unsatisfactory results due to ocular perforation, scarring, and melting. Intrastromal injection is a newer technique for delivering antimicrobials directly to the site of infection and has been successful in treating severe, treatment-resistant infectious keratitis, especially when surgery is not recommended. In cases where deep stromal disease is resistant to topical treatment, intrastromal antimicrobial injections may be necessary to achieve higher drug concentration at the infection site. However, the use of intrastromal antibiotics is limited, as topical antibacterial agents have better penetration than antifungal agents. Bacterial and fungal keratitis have been extensively researched for intrastromal medication injections, while there is limited evidence for viral keratitis. This review emphasizes the potential of intrastromal antimicrobial injections as an alternative for managing severe refractory infectious keratitis. The technique offers direct targeting of the infection site and faster resolution in some cases compared to topical therapy. However, further research is needed to determine the safest antimicrobials options, minimal effective doses, and concentrations for various pathogens. Intrastromal injections may serve as a non-surgical treatment option in high-risk cases, with benefits including direct drug delivery and reduced epithelial toxicity. Despite promising findings, more studies are required to confirm the safety and efficacy of this approach.

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Descemet′s membrane detachment caused by inadvertent vancomycin injection

Cited by 14 publications

References 8 publications

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

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

Descemet′s membrane detachment managed with perfluro-n-octane liquid

Intrastromal Injections in the Management of Infectious Keratitis

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