International Medical Case Reports Journal (Feb 2021)
A Case Report Illustrating the Spontaneous Vision Recovery After Inadvertent Central Descemetorhexis During Anterior Capsulotomy
Abstract
Drahomíra Baráková,1,2 Denisa Darsová1 1Gemini Eye Clinic a.s., Prague, Czech Republic; 2Department of Ophthalmology, Second Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech RepublicCorrespondence: Denisa DarsováGemini Eye Clinic a.s., U Křížku 572, Prague, Průhonice, 252 43, Czech RepublicEmail [email protected]: To demonstrate an unusual mechanism of iatrogenic, central descemetorhexis (DMR) during cataract surgery and subsequent rare spontaneous visual acuity improvement within 2 months after inadvertent surgical complication.Patients and Methods: A 81 year old woman underwent cataract surgery complicated by the loss of a 4.8X4.75 mm diameter central area of Descemet membrane. Perioperative video recording documented the DMR formation during continuous curvilinear capsulorhexis creation.Results: Postoperatively, severe corneal edema with folds in the remaining Descemet membrane were observed. The patient was managed conservatively. The corneal edema gradually resolved over 2 months with improving of visual acuity from counting fingers to 20/20.Conclusion: Unlike Descemet membrane detachment, descemetorhexis is a rare complication after intraocular surgery. The case report identifies a previously unknown mechanism of DMR formation during anterior capsulotomy creation. Loss of Descemet membrane may be managed conservatively in an otherwise healthy cornea with good final visual outcome without the need for surgical intervention.Keywords: cataract surgery, corneal edema, Descemet membrane detachment, descemetorhexis, loss of Descemet membrane, spontaneous vision recovery
