A new technique for repairing descemet membrane detachments using intracameral gas injection

Descemet membrane detachments are not uncommon following cataract surgery, and large and extensive detachments can have an impressive presentation, with severe corneal edema and marked reduction in visual acuity. Traditional treatment regimens have included observation (with the hopes of spontaneous resolution), anterior chamber injections of air or viscoelastic, transcorneal suturing, and even corneal transplantation for persistent cases. During the past few years, intracameral injection with either sulfur hexafluoride (SF6) or perfluoropropane (C3F8) gas has gained increasing acceptance as an efficient and effective treatment option for Descemet membrane detachments. Previously described techniques of gas injection have required corneal and paracentesis incisions; sterile blades, cannulas, and other instruments; and occasionally, an operating room setting. We describe a simple, safe, and effective technique for intracameral gas injection that can be performed by one person at the slitlamp microscope or in a minor operating room with minimal equipment.