ESCRS - PP26.05 - Descemet Stripping Only And Ripasudil For The Treatment Of Traumatic Descemet’S Membrane Ruptures

Descemet Stripping Only And Ripasudil For The Treatment Of Traumatic Descemet’S Membrane Ruptures

Published 2022 - 40th Congress of the ESCRS

Reference: PP26.05 | Type: Free paper | DOI: 10.82333/pme4-3175

Authors: Ester Fernández López* 1 , Elsie Chan 2 , Santiago Montolío Marzo 1 , María José Roig Revert 1 , Mikhail Hernández Díaz 1 , Cristina Peris Martínez 1

1FISABIO Oftalmología Médica,Valencia,Spain, 2Royal Victorian Eye and Ear Hospital,Melbourne,Australia

Purpose

Descemet´s membrane ruptures (with a discontinuation of Descemet´s membrane and double detached coiled edges) in the context of complicated anterior segment surgery have rarely been described and its management can be challenging. We report a modified Descemet stripping only (DSO) technique associated with ripasudil drops to treat these cases when other techniques fail.

Setting

FISABIO Oftalmología Médica (FOM) Valencia, Spain

Methods

We describe two cases of large Descemet´s membrane detachments associated with Descemet´s ruptures after complicated cataract surgery that did not respond to two SF6 intracameral injections. As the detached Descemet’s membrane and coiled edges might have prevented endothelial cell migration and preoperative endothelial cell density was normal, we decided to perform a modified DSO with post-operative ripasudil drops to promote corneal clearance. 

Results

Both cases improved significantly in unaided and best corrected visual acuity (BCVA), corneal clearance and pachymetry, avoiding the need for an endothelial keratoplasty. BCVA achieved was 20/21 in one case and 20/25 in the other, at the last follow up. Endothelial cells were observed on specular microscopy within the area of the descemetorhexis three months after surgery, achieving an endothelial cell density of 843 cells/mm2 and 591 cells/mm2 respectively at the last follow up.

Conclusions

DSO with ripasudil drops might be a valuable tool to recover corneal clearance and avoid endothelial keratoplasty in complex Descemet´s membrane detachments with ruptures that do not respond to other treatments.