The cause and treatment of post-operative Descemet's membrane detachmenta after surgery

Abstract

Objective To discuss the causes and therapeutic measures for Descemet's membrane detachment after intraocular operation. Methods A retrospective analysis of 15 eyes of 15 cases of postoperative Descemet's membrane detachment who had undergone phacoemulsification (11 eyes), extracapsular cataract extraction (1 eye), trabeculectomy (2 eyes) and removal of silicone oil(1 eye). The diagnosis of Descemet's membrane detachment were confirmed by anterior segment OCT, included 10 mild cases(10 eyes), 2 moderate cases (2 eyes)and 3 severe cases(3 eyes). Twelve patients of mild and moderate detachment underwent anterior chamber gas tamponade 3 days after operation (1 case with 20% C3F8). In 3 cases of severe detachment, anterior chamber gas tamponade was performed in 1 case two months after surgery, Descemet's stripping automated endothelial keratoplasty (DSAEK) was performed in 1 case 3months after the surgery, and one case abandoned further treatment. Results In 12 cases of mild and moderate Descemet's membrane detachment reseted in 10 cases within 3 days, and it reseted in 2 cases after a second time of gas injection. In 3 cases of severe detachment, 1 case got descemet membrane reset and cornea transparent partly one day after gas injection. Corneal graft attached to graft bed in 1 case. The case abandoning treatment developed bullous keratopathy. Conclusion Anterior segment OCT is an effective examining method for the diagnosis of Decemet's membrane detachment. The key to Descemet's membrane reattachment is to implement anterior chamber gas injection and thoroughly remove the interlaminar effusion. DSAEK is an effective treatment method. Key words: Endothelium, corneal; Transplantation; Descemet's membrane detachment; Optical Coherence Tomography, anterior segment, ocular; Anterior chamber gas tamponade