A case of inferior rhegmatogenous Descemet's membrane detachment after stromal hydration in cataract surgery

Abstract

We describe the uncommon case of an inferior rhegmatogenous Descemet's membrane detachment (DMD) from stromal hydration at the side port during cataract surgery that was successfully treated with pneumodescemetopexy and head posturing. A temporally located, transverse and inferior, DMD was noted during stromal hydration. An air bubble was inserted at the end of cataract surgery. This failed to appose the detached Descemet's membrane against the overlying stroma because of the inferior location of the detachment and the superior position of the bubble without appropriate head positioning. Corneal edema persisted with an associated visual acuity of counting fingers. Two weeks after initial cataract surgery, a further air bubble with appropriate head positioning (Trendelenburg, ie, feet up and head down) for 6 hours was performed. The patient's corneal edema and associated poor vision almost completely resolved within the 6 hours of air bubble reinsertion and appropriate head positioning. His corrected distance visual acuity remains at 6/6.