Two Cases of Spontaneous Reattachment of Descemet Membrane
Narrative Responses:
Purpose
The purpose of this paper is to describe two unique cases of spontaneous reattachment of Descemet's membrane.
Methods
Case #1: A 63 year old female with a history of CRVO and cystoid macular edema for which she received serial intravitreal kenalog injections. Following a steroid response to kenalog, she required placement of a Baerveldt glaucoma drainage device. After glaucoma surgery she developed hypotony. Healon was injected into the anterior chamber and inadvertently injected into the corneal stroma resulting in a Descemet's detachment.
Case #2: A 55 year old female who underwent DSEK surgery in her 4th penetrating keratoplasy for painful corneal edema in a failed graft. Post-operatively she had extensive interface fluid with near complete Descemet's detachment despite 2 attempts at rebubbling.
Results
Case #1: The patient experienced spontaneous reattachment of Descemet's membrane over a two month period following the Healon administration into the corneal stroma. Her vision improved dramatically with mild residual stromal scarring.
Case #2: The patient experienced spontaneous reattachment over a 1 month post-operative period. She experienced complete resolution of her pain with bandage contact lens independence and improvement in visual acuity.
Conclusion
Spontaneous reattachment of Descemet’s membrane may occur weeks after surgery or after mechanical separation of Descemet’s membrane from the corneal stroma and endothelium. This should be considered before pursuing aggressive surgical intervention or repeat surgical intervention, particularly in patients with a complicated past ocular history.