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Corneal edema resolution after "descemetorhexis"
Richard E Braunstein1, Suzanna Airiani, Margaret A Chang
1Edward S. Harkness Eye Institute, College of Physicians and Surgeons of Columbia University, New York, New York, USA. reb10@columbia.edu
Journal of Cataract and Refractive Surgery
|August 6, 2003
Summary
Descemet
Area of Science:
- Ophthalmology
- Corneal Surgery
- Cell Biology
Background:
- Phacoemulsification is a common cataract surgery technique.
- Descemet's membrane (DM) is a critical layer of the cornea.
- Accidental DM excision can lead to significant visual impairment.
Observation:
- A 79-year-old woman experienced inadvertent Descemet's membrane excision during phacoemulsification.
- Postoperative outcomes included severe corneal edema and poor visual acuity.
- The torn DM edge was visible as edema resolved over 6 months.
Findings:
- Central corneal endothelial cell density in the affected eye was 827 cells/mm² one year post-surgery.
- This finding suggests significant endothelial cell loss and dysfunction.
- Corneal endothelial cells may migrate to cover stromal defects in the absence of Descemet's membrane.
Implications:
- This case highlights a rare complication of phacoemulsification.
- Understanding endothelial cell behavior after DM damage is crucial for managing such cases.
- Further research may explore regenerative potential or novel treatment strategies for Descemet's membrane defects.