MANAGEMENT OF POST-CATARACT SURGERY DESCEMET'S MEMBRANE DETACHMENT: ANTERIOR SEGMENT OCT STUDY

To evaluate anterior segment optical coherence tomography (AS-OCT) in the diagnosis and treatment of Descemet's membrane detachment (DMD) after cataract surgery.

Ophthalmology Department, Military Hospital of Tunis, Tunisia.

Twelve eyes of 12 patients who presented DMD after cataract surgery, from January 2022 to September 2022, were imaged with the AS-OCT system. Configuration of Descemet's membrane (DM) was delineated before and after treatment, and quantitative analysis was performed. An appropriate treatment was chosen based on the imaging findings. Demographic details, type of cataract, type of cataract surgery, intraoperative complications, severity of DMD and post reattachment of the Descemet's membrane (DM) visual and clinical outcomes were also documented

The mean age was 62.2 ± 8.5 years . The incidence of DMD was higher in extracapsular cataract extraction (58 %) than phacoemulsification (41%). DMD was more common among surgical trainees (83 %) than consultants (17 %). Different statuses of the DM including planar/nonplanar detachment, local/extensive detachment, and rupture was documented using AS-OCT images. All cases had planar edges. In five cases, DMD was peripheral. Extensive detachment was noticed in three patients. Four patients were managed with topical steroid, 8 patients with primary air descemetopexy.  After primary air descemetopexy, five out of the 8 had DM reattachment. Two patients underwent repeat air descemetopexy for persistent DMD with successful reattachment. The complications noted after descemetopexy include persistent DMD (1patient) and pupillary block with air (1 patient).

AS-OCT is a useful tool for confirming the presence and extent of DMD, which can help determine the appropriate treatment. It can also be useful for identifying the intracameral injection site where the Descemet membrane was attached and for monitoring the recurrence of DMD after treatment.