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

Altıntaş, Ayşe; İlhan, Çağrı

doi:10.1177/2515841419853691

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…In these cases, DMD is usually noticed during surgery or in the early post-operative period associated with genetic factors and surgical technique. Late-onset DMD after cataract surgery is rarely reported [3].…”

Section: Introductionmentioning

confidence: 99%

Descemet’s Membrane Detachment Following Corneal Suture Removal: Case Report

HE,

et al. 2022

austinjclinopthalmol

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Introduction: Descemet’s Membrane Detachment (DMD) is the separation of the descemet’s membrane from the overlying corneal stroma. It is a rare and a potential vision-threatening complication of cataract surgery, with incidence rates being reported at 0.044–0.5% after phacoemulsification and 2.5% after extra capsular extraction. In these cases, DMD is mostly seen during surgery or in the early post-operative period and it is associated to surgical technique, surgical equipment or genetic factors. It is one of the most serious complications of cataract surgery, leading to irreversible corneal decompensation. Small DMD may resolve spontaneously, but most large detachments require interventions such as pneumodescemetopexy. Case Report: We report a 70-year-old female patient, without any underlying disease, presented with the complaint of decreased vision in her pseudophakic right eye after a 15-weeks silent post-extra capsular cataract extraction period and two weeks after corneal suture removal. On slit-lamp examination, massive corneal edema was noticed on the temporal periphery with the involvement of the visual axis. Anterior segment optical coherence tomography revealed the presence of DMD in the superotemporal quadrant. To provide reattachment of DMD, we performed an anterior chamber tamponade with air. No complication associated with descemetopexy was noticed during recovery. Total Descemet’s membrane reattachment was achieved. Discussion: Among all intraocular surgeries, DMD is most commonly described after cataract surgery. It generally occurs in early- postoperative period and late-onset DMD have been reported less frequently. It presents as localized or diffuse corneal edema. Anterior segment optical coherence tomography examination can be clearly used for observation of the position and the range of DMD. There are several ways to manage DMD: medical treatment, pneumodescemetopexy, penetrating keratotplasty and endothelial keratoplasty. To the best of our knowledge, this is the first reported case of DMD after corneal suture removal. Conclusion: DMD after cataract surgery is associated with a variety of factors. Anterior segment optical coherence tomography examination can be used to find clear detachment of the descemet’s membrane. The position of detachment and surgical incision were found to be closely related. The location and the scope of detachment can be used to guide clinical treatments and improve prognosis of patients.

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Section: Introductionmentioning

confidence: 99%

Descemet’s Membrane Detachment Following Corneal Suture Removal: Case Report

HE,

et al. 2022

austinjclinopthalmol

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Case Series of Descemet Membrane Detachment Associated with Cataract Surgery

Chung¹,

Jo²,

Lee³

2021

J Korean Ophthalmol Soc

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We report the therapeutic efficacy of using 18% SF6 injection into the anterior chamber or interrupted corneal sutures for Descemet membrane detachment related to cataract surgery. Case summary: Case 1) A 74-year-old female showed localized detachment of Descemet membrane of the cornea on the first day after cataract surgery on the left eye; her visual acuity was hand motion only. Non-expansible sulfur hexafluoride (18% SF6) gas was injected into the anterior chamber to treat the detachment and achieved improvement of vision due to relief of the corneal edema and adhesion of the Descemet membrane. Case 2) A 76-year-old male had poor visual acuity of the right eye after cataract surgery performed at a local eye clinic. Folding and detachment of the Descemet membrane was found before the postoperative 3-months follow-up. We injected 0.3 mL 18% SF6 gas into the anterior chamber twice. The corneal edema disappeared and visual acuity improved. Case 3) A 75-year-old female who had undergone cataract surgery was suspected of having Descemet membrane detachment. She was injected with 18% SF6 into the anterior chamber twice, but the detached membrane persisted in the lower right cornea, combined with pupillary block glaucoma. We performed interrupted corneal sutures of the detached Descemet membrane, and resolution of the detachment was confirmed by corneal optical coherence tomography. Conclusions: Re-attachment of Descemet membrane of the cornea can be obtained by performing repeated injections of 0.3-0.4 mL of non-expansible 18% SF6 gas, or by direct corneal suture in cases of persistent detachment.

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

Cited by 2 publications

References 21 publications

Descemet’s Membrane Detachment Following Corneal Suture Removal: Case Report

Descemet’s Membrane Detachment Following Corneal Suture Removal: Case Report

Case Series of Descemet Membrane Detachment Associated with Cataract Surgery

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