Clinical Efficacy Of Short-Term High-Pressure Intraocular Full-Air Tamponade (Shift) For Descemet Membrane Detachment After Cataract Surgery

Descemet membrane detachment (DMD) is a well-recognized and potential vision-threatening complication following cataract surgery and may lead to corneal decompensation and opacification if not managed appropriately. This study was to evaluate the clinical efficacy of short-term high-pressure intraocular full-air tamponade (SHIFT) for DMD after cataract surgery.

This retrospective study was carried out in Beijing Aier-Intech Eye Hospital, China.

Retrospective analysis of Short-term High-pressure Intraocular Full-air Tamponade (SHIFT) on patients with post-cataract DMD from April 2018 to December 2025. Intraoperatively, OCT-assisted air injection into the anterior chamber was performed to unfold/reattach the Descemet membrane, then air fillingto maintain intraocular pressure >40 mmHg for 2 hours, followed by releasing half of the air to relieve pupillary block.

21 patients (4 males and 17 females): 6 with moderate DMD (25%–50%  corneal involvement) and 15 with severe DMD (>50% corneal involvement). Prior to our treatment, 9 had failed 1–3 times of air injection in other hospitals. The mean interval from cataract surgery to our procedure was 15.6 days (3–45). All patients achieved Descemet membrane reattachment, but 4 underwent Descemet membrane endothelial keratoplasty due to corneal endothelial fragmentation caused by previous surgical interventions. Of 17 successfully managed cases, 5 had corrected distance visual acuity ≥20/40, 8 had 20/200–20/40, and 4 had <20/200 (3 with comorbidity factors affecting vision). Postoperative corneal endothelial cell count ranged from 500 to >2000 cells/mm².

SHIFT is an effective and rapid-recovery surgical approach for DMD after cataract surgery.