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. 2025 Mar 9;12(1):11.
doi: 10.1186/s40662-025-00428-2.

Iridectomy combined with posterior approach anterior chamber gas injection technique: a novel technique for the treatment of extensive Descemet's membrane detachment

Yu Shen  1 , Yongqiao Chen  1   2 , Fei Yin  1   3 , Luyi Zhang  1 , Xiaoxia Li  1 , Jing Wu  1 , Miaoqin Wu  4
Affiliations

Iridectomy combined with posterior approach anterior chamber gas injection technique: a novel technique for the treatment of extensive Descemet's membrane detachment

Yu Shen et al. Eye Vis (Lond). .

Abstract

Background: To present the iridectomy combined with posterior approach anterior chamber gas injection technique for the treatment of extensive Descemet's membrane detachment (DMD), which is a novel surgical approach for the management of DMD after phacoemulsification.

Case presentation: The surgical technique was performed on a 68-year-old female with a history of cataract phacoemulsification surgery and two times of anterior chamber gas injection to treat DMD. After creating a scleral tunnel at 4 o'clock of the limbus, the iris root in that direction was cut off. This was confirmed via an iris root incision indicating that the syringe needle entered the posterior chamber through the scleral tunnel. The anterior chamber was filled about 3/4 with 16% C3F8. After surgery, patients were required to maintain a supine position without pillows. One month post-surgery, the cornea was transparent, DMD had fully recovered, and the best corrected visual acuity improved to 20/20.

Conclusions: The iridectomy combined with a posterior approach anterior chamber gas injection technique can be used as an alternative surgical option for the management of extensive DMD in patients who have undergone several ineffective anterior chamber gas injection surgeries.

Keywords: Descemet’s membrane; Descemet’s membrane detachment; Iridectomy; Posterior approach anterior chamber gas injection.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the Ethics Committee of Zhejiang Provincial People's Hospital (2021QT378). Written informed consent was obtained from the patient. Consent for publication: Written informed consent for publication was obtained from the participant. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Morphological changes of Descemet’s membrane on AS-OCT. a–c AS-OCT showed extensive DMD throughout the cornea, without obvious scrolling. d–f AS-OCT showed that the DMD was aggravated and adhered to the surface of iris. g–i AS-OCT indicated the reattachment of Descemet’s membrane, accompanied by a slightly rough internal surface. j–l DMD had completely disappeared, and the cornea was transparent with no bubble in the anterior chamber. The yellow arrows represent the detached Descemet’s membrane, and the blue arrows represent the bubble. AS-OCT, anterior segment optical coherence tomography; DMD, Descemet’s membrane detachment
Fig. 2
Fig. 2
Surgical procedures performed in the iridectomy combined with posterior approach anterior chamber gas injection technique. a A scleral tunnel has been created at the 4 o'clock position of the limbus. b The iris root in that direction was cut off. c The pupil was constricted. d The syringe needle has entered the posterior chamber through the scleral tunnel and injected gas. e A bubble in the anterior chamber
Fig. 3
Fig. 3
Diagrammatic illustration of the iridectomy combined with posterior approach anterior chamber gas injection technique. a Create a scleral tunnel at the inferior-temporal quadrant of the limbus. b Cut off the iris root in that direction. c Constrict the pupil. d The syringe needle enters the posterior chamber through the scleral tunnel and injects gas. e A bubble in the anterior chamber
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