Treatment of iatrogenic detachment of Descemet’s membrane after cataract phacoemulsification with intraocular lens implantation. Analysis of the problem and a clinical case report

Abstract

Purpose. To evaluate the efficiency of the complex treatment of Descemet’s membrane detachment.Material and methods. In case of failure of therapeutic methods of treatment of induced keratopathy, a 65-year patient underwent an optical coherence tomography of the anterior segment, and a total detachment of the Descemet’s membrane was detected. The injection of sterile air was performed into the anterior chamber of the patient and the transepithelial puncture of the cornea was carried out in order to drain the fluid located between the Descemet’s membrane and the posterior surface of the corneal stroma.Results. The patient underwent pneumopexy of the Descemet’s membrane with transepithelial puncture of the cornea in order to drain the fluid located between the Descemet’s membrane and the posterior surface of the corneal stroma associated with the standard keratoplastic and anti-inflammatory therapy. The postoperative period was without complications. During the examination a week later, a complete absence of subjective symptoms (pain, lacrimation, foreign body sensation, photophobia) was revealed, objectively the edema of all corneal layers was significantly reduced. The visual acuity of the operated eye increased from 0.05 n/c to 1.0.Conclusion. In case of total detachment of the Descemet’s membrane the application of thee sterile air injection into the anterior chamber with the transepithelial puncture of the cornea in order to drain the fluid between the Descemet’s membrane and the posterior surface of the corneal stroma, leads to its complete attachment, an arrest of the corneal syndrome and an improvement of visual acuity.

Keywords

• descemet’s membrane
• keratopathy
• pneumopexy