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Descemet’s membrane detachment as a complication after phacoemulsification treated with descemetopexy

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Session Details

Session Title: Presented Poster Session: Complications Management in Cataract Surgery

Venue: Poster Village: Pod 1

First Author: : L.Aguilera SPAIN

Co Author(s): :    J. Ramos Navarro   Y. Fernandez   C. Perez Casaseca   J. Garrido Linares   L. Gonzalez Garcia  

Abstract Details

Purpose:

The detachment of Descemet's membrane of the cornea is a rare but potentially vision-threatening complication of any surgery of the anterior eye segment. Its identification and the actions to be taken in case it occurs are a necessary knowledge for any ophthalmologist.

Setting:

Clínica Baviera Málaga.

Methods:

A 68 year-old woman who underwent cataract surgery by phacoemulsification and intraocular multifocal lens implantation without complications in both eyes. On the first postoperative day of the left eye (OS), the visual acuity was counting fingers from 1 meter, biomicroscopy showed localized corneal edema around main incision extending to the visual axis and a detachment of Descemet's membrane but without scroll, the intraocular pressure (IOP) was 15 mm Hg. An anterior segment optical coherence tomography (AS-OCT) confirmed the diagnosis. Descemetopexy was performed in the operating room using topical anesthesia, a 30G cannula and a 5-ml syringe filled with 100% air.

Results:

After 24 hours the corneal edema was improved but the Descemet's membrane was not completely attached, the air bubble was reduced significantly. It is decided to repeat the surgical procedure to fills 2/3 of the anterior chamber with air and the patient was advised to lie down in a supine position. On day 1 after the second air injection, the Descemet's membrane was attached, the AS-OCT image showed Descemet’s membrane apposed to the posterior stroma. One month later the visual acuity was 1. The cornea was clear with only three thin folds and Descemet's membrane was attached.

Conclusions:

Descemet’s membrane detachment is a rare but potentially serious complication after cataract surgery, it can be treated effectively and good visual outcomes can be expected if the patient is treated in time with anterior chamber injection of air. The mean time for resolution of DMD with medical treatment alone was reported to be 9.8 weeks with a high failure rate of 46.67%. On the other hand, the success rates with descemetopexy have been reported to be 90–95%. Air has advantages of better efficacy than other gases without the risk of pupillary block.

Financial Disclosure:

NONE

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