Cornea Cases
Title:
Approach to the Descemet’s membrane detachment which noticed late period after cataract surgery
Case Report Details
First Author: E.Bozkurt TURKEY
Co Author(s): E. Muhafiz
Abstract Details
Purpose:
We aimed to present the differential diagnosis and treatment of Descemet membrane detachment (DMD) in a patient with acute corneal edema after phacoemulsification surgery.
Setting:
Kafkas University, Medicine Faculty, Department of Ophthalmology
Report of case or case series:
A 52-year-old female patient presented to our clinic with acute corneal edema and visual impairment secondary to DMD, which was noticed on the 16th postoperative day after routine phacoemulsification surgery in the left eye. Visual acuity of the case was seen at the 16th postoperative day 0.1 LogMAR in the right eye and from 50 cm in the left eye at level of counting finger . In biomicroscopic examination nuclear sclerosis in the right eye, diffuse corneal edema except the upper temporal region in the left eye was followed. Intraocular pressures were normal in both eyes. On fundus examination, the right eye was normal and the left eye was normal ultrasonographically like the right eye although cannot be evaluated clearly. Anterior segment optical cohorens tomography (ASOCT) was performed with suspicion of DMD. ASOCT images showed a hyperreflective band forming a second anterior chamber under epithelial and stromal edema. The patient was being diagnosed with DMD and corneal edema related with this and C3F8 injection was made into the anterior chamber. On the third day following the injection, the cornea was transparent except for paracentral descemet wrinkles, there was gas appearance in the anterior chamber and visual acuity increased to 0.7 LogMAR level.
Conclusions/Take Home Message:
Since the air given to the anterior chamber is completely absorbed within 24-48 hours, air should be given to the anterior chamber several times in DMD. C3F8 gas can reduce the number of surgeries as it provides a longer tamponade than air. This case shows us that intracameral C3F8 gas injections are an effective treatment modality in DMDs exceeding two weeks.
