Ophthalmic Surgery, Lasers and Imaging Retina

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Clinical Science 

Descemet's Membrane Detachment Following Phacoemulsification

Jaspreet Sukhija, MD; Jagat Ram, MD; Sushmita Kaushik, MD; Amod Gupta, MD

Abstract

BACKGROUND AND OBJECTIVE

To determine the management options and the indications for surgical intervention in Descemet’s membrane detachment (DMD) after phacoemulsification.

PATIENTS AND METHODS

Clinical records of 11 consecutive eyes (11 patients) with DMD were reviewed. All cases had undergone phacoemulsification with posterior chamber intraocular lens implantation. Patients with DMD involving one-third or more of the cornea were analyzed.

RESULTS

All patients underwent clear corneal phacoemulsification. In three cases where the detachment was recognized intraoperatively, perfluoropropane gas was injected. Eight eyes (8 cases) had unexpected corneal edema detected as DMD postoperatively and managed by injecting perfluoropropane gas into the anterior chamber. Three eyes that required repeated surgical intervention postoperatively had more than 50% corneal involvement with significant separation of the membrane from the stroma and curling or folding of the membrane. At last follow-up, 10 eyes retained clear corneas and one had residual DMD not involving visual axis. All 11 eyes had best-corrected visual acuity of better than 6/12.

CONCLUSION

DMD should be suspected in patients showing unexpected corneal edema postoperatively who have undergone uneventful phacoemulsification and be treated in a timely manner. Surgical intervention is recommended in cases with significant separation of the membrane from stroma and curling or folding of the Descemet’s membrane.

[Ophthalmic Surg Lasers Imaging 2010;41:512-517.]

Abstract

BACKGROUND AND OBJECTIVE

To determine the management options and the indications for surgical intervention in Descemet’s membrane detachment (DMD) after phacoemulsification.

PATIENTS AND METHODS

Clinical records of 11 consecutive eyes (11 patients) with DMD were reviewed. All cases had undergone phacoemulsification with posterior chamber intraocular lens implantation. Patients with DMD involving one-third or more of the cornea were analyzed.

RESULTS

All patients underwent clear corneal phacoemulsification. In three cases where the detachment was recognized intraoperatively, perfluoropropane gas was injected. Eight eyes (8 cases) had unexpected corneal edema detected as DMD postoperatively and managed by injecting perfluoropropane gas into the anterior chamber. Three eyes that required repeated surgical intervention postoperatively had more than 50% corneal involvement with significant separation of the membrane from the stroma and curling or folding of the membrane. At last follow-up, 10 eyes retained clear corneas and one had residual DMD not involving visual axis. All 11 eyes had best-corrected visual acuity of better than 6/12.

CONCLUSION

DMD should be suspected in patients showing unexpected corneal edema postoperatively who have undergone uneventful phacoemulsification and be treated in a timely manner. Surgical intervention is recommended in cases with significant separation of the membrane from stroma and curling or folding of the Descemet’s membrane.

[Ophthalmic Surg Lasers Imaging 2010;41:512-517.]

Authors

From Advanced Eye Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

Originally submitted March 1, 2009. Accepted for publication April 22, 2010. Posted online June 30, 2010.

The authors have no financial or proprietary interest in the materials presented herein.

Address correspondence to Jagat Ram, MD, Department of Ophthalmology, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.

10.3928/15428877-20100625-02

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