Persistent Corneal Edema After Uneventful Cataract Surgery: A Delayed Diagnosis Of Descemet Membrane Detachment

To present a case of delayed diagnosis of Descemet membrane detachment (DMD) following uneventful cataract surgery and to emphasize the importance of anterior segment optical coherence tomography (AS-OCT) in patients with persistent postoperative corneal edema.

Tertiary referral eye center specializing in anterior segment surgery.

A 72-year-old patient underwent uncomplicated phacoemulsification with posterior chamber intraocular lens implantation. On postoperative day 1, reduced visual acuity and diffuse corneal edema were observed, with normal intraocular pressure. The findings were initially attributed to transient endothelial dysfunction, and topical medical therapy was initiated.

Despite treatment, corneal edema persisted without improvement. On postoperative day 7, AS-OCT was performed, revealing a planar Descemet membrane detachment involving the central cornea. An intracameral air injection (descemetopexy) was promptly performed.

Follow-up AS-OCT confirmed complete reattachment of the Descemet membrane within one week, with gradual resolution of corneal edema. Best-corrected visual acuity improved significantly during follow-up.

Persistent corneal edema after cataract surgery should prompt evaluation for Descemet membrane detachment. Clinical examination alone may be insufficient, and early use of AS-OCT is essential for accurate diagnosis. Timely intervention with descemetopexy can lead to excellent anatomical and visual outcomes.