Posters

Descemethocele as a late complication of cataract surgery

Poster Details

First Author: M. Gessa SPAIN

Co Author(s):    F. Espejo Arjona   M. Caro Magdaleno   J. Gimenez-Almenara Amo              

Abstract Details

Purpose:

To describe the clinical case of a patient who developed Descemethocele 5 months after complicated cataract surgery and the management of this situation. The objective is to avoid corneal perforation and try to do penetrating keratoplasty when the situation is controlled and no inflamation is in the eye, in order to get the maximum visual acuity.

Setting:

Clinical study and surgical process. Photographies of clinical state before and after surgery are included

Methods:

Clinical case. Women, 63 years. Cataract surgery with posterior capsule tear and lens mass luxation to vitreous. One day after that it´s performed vitrectomy without complications and IOL implant. After vitrectomy there is a corneal ulcer which doesn´t epithelizes, and progress to stromal infiltrate and descemethocele. Hypopyon is stablished. Treatment with oral tetracyclines and topical moxifloxacin,cicloplegyc, medroxiprogesterone but no corticoids because of the risk of perforation. Amniotic membrane transplant mutilayer is done, but 10 days after a big perforation occurs. Penetrating keratoplasty is performed with 16 interrupted suture.

Results:

BCVA: hands movement. IOP:28. BMC: Transparent keratoplasty without complications. Urretzs-Zavallia syndrome. Fundus: optic atrophy

Conclusions:

The goal of the descemethocele treatment is to restore integrity of the ocular surface as soon as possible and prevent perforation.Currently we have different options : tissue adhesives , amniotic membrane ,corneal patch , penetrating keratoplasty. In our case we opted for the amniotic membrane transplant because of the effect against inflammation and regenerating ocular surface . Because drilling, conducted penetrating keratoplasty , successfully ,but with the risk of being performed “hot” Unfourtunately, due tu optic atrophy, the patient only can see hands movement, but the ocular integrity has been restore

Financial Disclosure:

NONE