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Descemet’s membrane detachment following corneal suture removal

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First Author: H.El Belidi MOROCCO

Co Author(s):    Y. Saoiba   O. Cherkaoui                 

Abstract Details

Purpose:

Descemet’s membrane detachment is the separation of the descemet’s membrane from the overlying corneal stroma and is a rare complication of intraocular surgeries with incidence rates being reported at 2.5% and 0.044–0.5% during extracapsular cataract extraction and phacoemulsification, respectively . In these cases, descemet’s membrane detachment is mostly seen during surgery or in the early post-operative period associated with surgical technique, surgical equipment or genetic factors . It is one of the most serious complications of cataract surgery ,leading to irreversible corneal decompensation. Small descemet’s membrane detachment may resolve spontaneously, but most large detachments require interventions such as pneumodescemetopexy .

Setting:

HOPITAL DES SPECIALITES . RABAT. MOROCCO

Methods:

We report a 70-year-old female patient presented with the complaint of decreased vision in her pseudophakic right eye after a 13-weeks silent post-extracapsular cataract extraction period and one week after corneal suture removal. In the biomicroscopy, corneal oedema was seen to be prominent on the nasal incision side. Anterior segment optical coherence tomography revealed the presence of descemet’s membrane detachment in the superior quadrant . Treatment of descemetopexy was applied . No complication associated with descemetopexy was noticed during recovery. Total Descemet’s membrane detachment reattachment was achieved .

Results:

Among all intraocular surgeries, Descemet's membrane detachment is most commonly described after cataract surgery .It generally occurs in early-postoperative period and late-onset descemet's membrane detachments have been reported less frequently.It presents as localized or diffuse corneal edema . Anterior segment optical coherence tomography examination can be clearly used for observation of the position and the range of descemet's membrane detachment .There are several ways to manage descemet's membrane detachment : medical treatment , pneumodescemetopexy, ,penetrating keratotplasty and endothelial keratoplasty . To the best of our knowledge, this is the first report of descemet's membrane detachment after corneal suture removal .

Conclusions:

Descemet's membrane detachment after cataract surgery is associated with a variety of factors. Anterior segment optical coherence tomography examination can be used to find clear detachment of the descemet's membrane . The position of detachment and surgical incision were found to be closely related. The location and the scope of detachment can be used to guide clinical treatments and improve prognosis of patients.

Financial Disclosure:

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