Incidence Of Descemet Membrane Detachment Research Articles

Evaluation of corneal incision in femtosecond laser-assisted phacoemulsification.

This study aimed to evaluate the accuracy and quality of healing of main corneal incisions in femtosecond laser procedures in cataract surgery. It was a prospective, non-randomized, investigator-masked study. A total of 37 eyes of 37 patients with indication for cataract surgery were separated into two groups in this prospective, nonrandomized study: Femto group, with incisions automated by femtosecond laser (18 eyes), and Phaco group, with incisions made using a keratome (19 eyes). The planned incisions were 2.2 mm wide and 1.65 mm long. The length of the incision and prevalence of endothelial gap, endothelial misalignment, and localized Descemet Membrane Detachment (DMD) were compared. The mean incision length was statistically higher in the Femto group in two examinations: 1.64 mm ± 0.16 vs. 1.43 mm ± 0.30 (p = 0.001) in Exam 1 (between 2 and 4 days) and 1.58 mm ± 0.22 vs. 1.27 mm ± 0.34 (p < 0.0001) in Exam 2 (between 1 and 3 months). No eye presented an endothelial gap in Exam 2. The endothelial gap was higher in the Femto group in Exam 1. In the two examinations, endothelial misalignment was lower in the Femto group, whereas the incidence of DMD was lower in the Femto group in the two examinations. Automated incisions with femtolaser presented a higher mean length and lower DMD prevalence compared to manual incisions with a keratome.

Incidence of Descemet Membrane Detachment after Phacoemulsification Cataract Surgery in a Sample of Iraqi Patients at Ibn Al-Haitham Teaching Eye Hospital

Incidence of Descemet Membrane Detachment after Phacoemulsification Cataract Surgery in a Sample of Iraqi Patients at Ibn Al-Haitham Teaching Eye Hospital

Descemet Membrane Detachment Due to Laser Application in Femtosecond Laser-Assisted Cataract Surgery: Incidence and Risk Factors.

To assess the incidence and risk factors of Descemet membrane detachment due to laser application in femtosecond laser-assisted cataract surgery (FLACS). In this retrospective case series, all patients who underwent FLACS with the LenSx system (Alcon Laboratories, Inc) were eligible to participate. The medical records were reviewed to collect data regarding potential risk factors related to Descemet membrane detachment, including patients' demographics, laser parameters, and ocular measurements. The eyes were separated into two groups based on the clinical diagnosis of Descemet membrane detachment as the femto-second laser was performing the corneal incisions. Five hundred ten eyes (304 patients) were included. Descemet membrane detachment occurred in 20 (3.9%) eyes of 16 (5.3%) patients. Four (1.3%) patients had a detachment in both eyes. In 16 (3.1%) eyes, the Descemet membrane detachment occurred in the secondary incision site. The eyes that had a detachment had a statistically lower mean endothelial cell density (2,193.40 ± 313.37 versus 2,385.08 ± 357.80 cells/ mm2; P = .019), and a statistically higher prevalence of corneal guttata (25.0% versus 8.8%; P = .015). None of the other analyzed variables statistically differed between the groups (P > .05). The risk of having Descemet membrane detachment was statistically higher among eyes with guttata (odds ratio = 3.47; P = .015) and in those with an endothelial cell density of less than 2,000 cells/mm2 (odds ratio = 3.26; P = .014). The incidence of Descemet membrane detachment due to laser application in FLACS was 3.9%, with the associated risk factors being endothelial cell density of less than 2,000 cells/mm2 and corneal guttata. [J Refract Surg. 2021;37(7):466-471.].

Effect of manual, preloaded, and automated preloaded injectors on corneal incision architecture after IOL implantation.

To analyze the effects on corneal morphology of manual, preloaded, and automated preloaded intraocular lens (IOL) injectors in eye bank human corneas by environmental scanning electron microscopy (ESEM) and in patients after phacoemulsification using anterior segment optical coherence tomography (AS-OCT). Eye Clinic, Careggi University Hospital, Florence, Italy. Retrospective and experimental study. Seventy-eight corneal incisions were examined after IOL implantation: 30 in human corneas mounted on an artificial chamber using ESEM (ex vivo); 48 in patients undergoing phacoemulsification (in vivo). Three different injectors were used for both analyses: manual (Monarch III, n = 26), manual preloaded (UltraSert, n = 26), and automated preloaded system (AutonoMe, n = 26). Thirty IOLs were implanted in the ex vivo study: 5 intermediate and 5 high dioptric powers for AcrySof IQ (Monarch and UltraSert) and for Clareon (AutonoMe) IOLs. In the in vivo analysis, 16 corneal wounds for each injector were evaluated using AS-OCT; in the ex vivo study, incision width was measured and Descemet membrane detachment, posterior wound retraction, and posterior gape were analyzed. In the eye bank corneas, the incision width was significantly wider in the high dioptric power IOL manual subgroup (P < .05), with more Descemet tearing compared with AutonoMe. In the in vivo study, the incidence of Descemet membrane detachment, posterior gape, and wound retraction was lower in the automated preloaded group at 1 postoperative day 1. The automated preloaded injector ensured less trauma to the wound and contributed to preserving the endothelial side of the incision even during the implantation of high-power IOLs and in the early postoperative period.

Descemet's membrane detachment following uneventful phacoemulsification surgeries: A case report.

Rationale:Descemet's membrane detachment (DMD) may occur during or following cataract surgery, causing corneal edema and visual loss1. The incidence of DMD after phacoemulsification surgery is only approximately 0.5%, and mostly surgical-related. Late onset bilateral spontaneous DMD after sequential uneventful cataract surgeries, is even rarer, and may result from not only surgery itself, but also from an underlying anatomic abnormality 2.Patient concerns:We present a 80 year old female developed bilateral descemet's membrane detachment after sequential uncomplicated cataract surgeries.Diagnosis:Bilateral Descemet's membrane detachment.Interventions:One eye (left eye) was treated with intracameral air injection and the fellow eye (right eye) was treated with medical treatment only.Outcomes:The DMDs were reattached in both eyes after treatment. Surgical intervention accelerated the duration of recovery and there were no significant outcome differences between the right and the left eye.Lessons:Even if there is a large area of DMD with visual axis involvement, conservative treatment with close observation might still provide a satisfactory result if Descemet's membrane is separated from the posterior corneal stroma by ≤1 mm.

Descemet membrane detachment in femtosecond laser-assisted cataract surgery: a case report

sBackgroundFemtosecond laser-assisted cataract surgery (FLACS) has grown in popularity among ophthalmologists as a novel technique. However, descemet membrane detachment (DMD) began to be found as the complication after FLACS. We report a case of serious DMD following FLACS due to the inappropriate incision design.Case presentationAn 85-year-old man with apparent cornea arcus senilis underwent femtosecond laser-assisted cataract surgery in his right eye. A biplanar model was chosen for the main incision. A serious descemet membrane detachment (DMD) occurred at the end of phacoemulsification, which was connected with the main incision. However, the surgeon confused it with the transient swelling of corneal endothelium, and did not treated DMD timely. DMD was confirmed by anterior segment optical coherence tomography (AS-OCT) at the postoperative 1-month follow-up. Eventually DMD was resolved by intracameral perfluropropane (C3F8) gas injection.ConclusionsThis case suggests that a careful incision separation and a triplanar incision design in FLACS may reduce the incidence of DMD in cataract surgery.

Descemet Membrane Detachment After Canaloplasty

To report the incidence and management of Descemet membrane detachment (DMD) after canaloplasty. Review of all patients who developed DMD after canaloplasty at Tulane Glaucoma Services was performed. Visual acuity, intraocular pressure, and number of glaucoma medications up to 1 year of follow-up were included in the analysis. The incidence of DMD was 7.4% (12 eyes of 162). Eighty-three percent (10/12) of the DMDs involved the inferior quadrants and measured <3 mm. Intracorneal hemorrhage within DMD occurred in 58% (7/12), whereas 42% (5/12) developed DMD with intracorneal viscoelastic (Healon GV) alone. Two patients had large detachments measuring 5 to 6 mm extending into the visual axis. DMD resolved completely with or without drainage except for 1 patient who developed corneal decompensation, needing penetrating keratoplasty. DMD with or without intracorneal hemorrhage is not an infrequent complication of canaloplasty and can occasionally lead to corneal decompensation.

Early Changes in Morphology and Intraocular Pressure by Size of Clear Corneal Incision

We compared changes in morphology and intraocular pressure (IOP) induced by clear 2.2-mm and 3.0-mm corneal incisions in a cohort of patients with cataracts. In 160 eyes (from 70 men and 90 women at the Ophthalmic Center of Sun Yat-sen University), optical coherence tomography and tonometry were performed at 1, 5, and 24 hours after cataract surgery. The main outcome measures were IOP, postoperative changes in Descemet membrane detachment (DMD), healing of the surgical incision, and inflammation of the anterior chamber. Five hours after surgery, patients with 2.2-mm and 3.0-mm incisions had lower IOPs (P < 0.017) as measured by noncontact tonometry, but the difference was significant only among patients with grade V cataracts (2.2 mm, 12.6 ± 1.2 mm Hg; 3.0 mm, 14.5 ± 0.9 mm Hg, P < 0.05). The incidence of endothelial gap at 24 hours after surgery was significantly higher in the 2.2-mm (50%) versus 3.0-mm (11.1%) group of patients with grade V cataracts (P < 0.05). The incidence of DMD at 5 hours was also significantly higher in the 2.2-mm group (75%) than in the 3.0-mm group (22.2%) only among patients with this grade (P < 0.05). Incision width made no difference among patients with grade I-IV lens nuclei; but among those with grade V, 3.0-mm incisions had significantly less endothelial gaping, less DMD, and higher mean IOPs. For these patients, smaller incisions may not be optimal, and eyes may be especially vulnerable within 5 hours of surgery.