Role of Optical Coherence Tomography in Predicting Outcomes in Post-Cataract-Surgery Descemet Membrane Detachment
Purpose
To characterize the anterior segment optical coherence tomography (OCT) features of Descement’s membrane detachment (DMD) after cataract surgery and to assess the role of OCT in predicting the need for descemetopexy.
Methods
Retrospective evaluation of clinical notes and OCT images of 56 eyes of 56 patients who had DMD after cataract surgery between 2010 and 2013. Patients were divided into two groups, Group-1 (22 eyes, no intervention) and Group-2 (34 eyes, descemetopexy) based in intervention. Demographics, anatomical (OCT) features (quadrants of detachment, height of maximum detachment, width of maximum detachment, distance between edges if a break is identified, central corneal thickness, corneal thickness at the area of maximum detachment) and functional (corrected distance visual acuity) details were evaluated and compared at baseline and at 3 months between the two groups.
Results
The base line characteristics were comparable between the two groups except for the width of maximum detachment, which was more in group-2 (p=0.01). Visual acuity was significantly improved from baseline in both groups (p<0.01) but there was no statistical difference between the groups. Repeat descemetopexy was needed in 5 eyes and endothelial keratoplasty in 2 eyes in group-2. Eighty-eight percent eyes had attached descemet’s membrane with clear cornea in group-1. No association of final visual outcome was observed with age, sex, cataract grade, preoperative visual acuity and involvement of the visual axis.
Conclusion
Spontaneous attachment of descemet’s membrane can be anticipated with good anatomical and functional outcomes after post-cataract surgery DMD. Features of OCT help us in understanding the nature of detachment and for planning descemetopexy but may not help in prognosticating.