Descemet's Membrane Endothelial Keratoplasty (Dmek) In A Patient With Traumatic Detachment Of Descemet's Membrane During Delivery.
Published 2024 - 42nd Congress of the ESCRS
Reference: PO093 | Type: Case Report | DOI: 10.82333/xkng-b423
Authors: Alba González Corte* 1 , Sara Valdés Alvarez 1 , Ana Señaris González 1 , Marta Alvarez Coronado 1 , María Fernández García 1
1Service of Ophtalmology,Hospital Universitario Central de Asturias,Oviedo,Spain
Purpose
Describe a clinical case of corneal lamellar surgery in a special situation.
Setting
One of the complications that can be encountered after forceps trauma during delivery is Descemet's membrane detachment. This pathology can go unnoticed due to its low incidence, and can lead to severe visual debilitation and amblyopia in childhood.
Report of case
We present the case of a 28-year-old woman who consulted for corneal decompensation in the right eye (OD), diagnosed 3 months ago, under treatment with Therapeutic Contact Lens.
She has a history of forceps trauma during childbirth with Descemet's membrane rupture in the right eye, amblyopia, and myopia in that eye. She undergoes annual controls with visual acuity around 20/200.
On examination, the patient had a corrected visual acuity of 20/200 in the OD and 20/20 in the left eye (OS). Biomicroscopy of the OD shows bullous keratopathy with inferior bulla, central ring of detached endothelium and a formed anterior chamber. The OI biomicroscopy is normal.
The fundus is normal in both eyes.
The possibility of corneal lamellar surgery is suggested to the patient and, after 3 months, DMEK is performed in OD with previous iridotomy, without incidences.
One year after surgery, the corrected visual acuity is 20/60, the cornea is clear and the graft remains attached.
Conclusion/Take home message
Descemet's membrane detachment is a possible complication of forceps trauma during delivery that can lead to lifelong visual problems. It is important to detect it with good perinatal care and, once diagnosed, early correction is indicated to prevent the development of amblyopia. DMEK may be a therapeutic option in these patients to prevent or treat corneal decompensation.