Retrospective Analysis of Management of Descemet Membrane Detachment After Uneventful Cataract Surgery
Descemet's membrane detachment is a rare but serious complication following cataract surgery. Extensive detachments that affect the visual axis may result in poor vision and if not managed properly may require lamellar corneal surgery A retrospective analysis of management of DM detachment over a one year period at a tertiary referral hospital was done.
Twenty-one eyes of 21 patients presented with DM detachment involving the visual axis. The time of referral ranged from 1 day to 1 month .81% (17 eyes) had a temporal detachment, 3eyes (14%) had a superior detachment,1 eye (4.7%) had an inferior detachment. Total DM detachment was present in 6 eyes (28.5%). All the eyes underwent intracameral air injection as a primary procedure to reattach Descemet's membrane. Repeat air injection was required in 4 out of 21 eyes. 2 patients had non expansile c3f8 injection as a secondary modality. One patient had transcorneal suturing done.
Fourteen eyes had successful reattachment of Descemet's membrane after the primary air injection with clearing of corneal edema & improvement in visual acuity. The response to primary air injection was better in early referrals (71%) patients with longer history needed repeat procedures (7%). Patients with a single detachment responded better than patients with multiple areas of detachment. All patients ultimately responded to the intervention.
DM detachment, though a serious problem needs immediate intervention. Improvement in visual acuity is fast, the method is safe, effective and easily performed under topical anesthesia.