Successful treatment of late onset post-phacoemulsification Descemet's membrane detachment

Abstract

Purpose: To present a case with the late-onset post-phacoemulsification Descemet's membrane detachment that has been treated successfully.

Methods: Case report.

Results: A 68-year-old female patient presented with the complaint of decreased vision in her pseudophakic left eye after a 4-week silent post-phacoemulsification period. In the biomicroscopy, corneal oedema was seen to be prominent on the nasal incision side. Anterior segment optical coherence tomography objectively revealed the presence of Descemet's membrane detachment. Treatment of descemetopexy was applied by injecting 0.3-mL perfluoropropane gas into the anterior chamber. No complication associated with descemetopexy was noticed during recovery. Total Descemet's membrane detachment reattachment was achieved and perfluoropropane gas resorption from the anterior chamber was completed by the end of 1-month post-injection. The cornea was transparent and best corrected visual acuity increased to 20/20.

Discussion: DMD is a rare complication following phacoemulsification and this patient had not any preoperative, intraoperative, or postoperative risk factors for DMD.It generally occurs in early-postoperative period and late-onset DMDs have been reported less frequently.The success rates with intracameral gas injections in similar cases have been reported to be 90% - 95%.

Conclusion: To the best of our knowledge, this is one of the latest onset post-phacoemulsification Descemet's membrane detachment cases in literature that has been treated successfully. The results of this case showed that descemetopexy is a safe and effective treatment method for late-onset post-phacoemulsification DMD.

Keywords: Descemet’s membrane detachment; descemetopexy; phacoemulsification.

Figure 1.

Corneal topography images: (a) before descemetopexy and (b) after descemetopexy.

Figure 2.

Anterior segment optical coherence tomography images. (a-c) Descemet’s membrane detachments at different sections, (d) post-descemetopexy first week, (e, f) post-descemetopexy second week.