Posters

A peculiar case of recurrent late Descemet’s membrane detachment following an uncomplicated cataract surgery

Poster Details

First Author: K. Chopra INDIA

Co Author(s): V. Bhandari   S. Ganesh                 

Abstract Details

Purpose:

We report the case of a 79-year-old female who developed Descemet's Membrane (DM) detachment in the Left eye, 2 weeks after a temporal clear corneal phacoemulsification with posterior chamber lens implant with viscoelastic injection. The DM detachment was treated with pneumatic descemetopexy and transcorneal suturing. However, the attempted reattachment of the membrane was only temporarily successful. An anatomic predisposition may be implicated, because the fellow eye exhibited similar course of events culminating in a decompensated cornea. Both eyes showed low Endothelial cell density pre-operatively.

Setting:

Nethradhama Superspecialty Eye Hospital, Bangalore, India.

Methods:

The patient underwent temporal clear corneal phacoemulsification with IOL implantation in the left eye. Given the predisposition in the fellow eye, precautions were made to avoid intraoperative DM detachment. On the fifteenth postoperative day, she presented with sudden onset of painless diminution of vision in the Left eye, with BCVA of 1 logMAR, N36. A large central DM detachment was noticed. She underwent transcorneal suturing and pneumatopexy twice within a span of 1 week but the detachment persisted.

Results:

Despite undergoing an uneventful temporal clear corneal phacoemulsification with IOL implantation followed by pneumatopexy and transcorneal sutures in the left ye, it was noticed that while at the sutured areas the Descemet’s membrane remained attached, shallow central detachment persisted. The patient is now awaiting keratoplasty.

Conclusions:

In this case, despite rigorous management, there was recurrent detachment of the Descemet’s membrane, which may be attributed to low endothelial cell density and compromised endothelial function. It should be emphasized that delayed corneal edema can be related to late-onset Descemet's membrane detachment, which requires proper treatment to avoid permanent corneal decompensation.

Financial Disclosure:

None