Usefulness of anterior segment optical coherence tomography in Descemet membrane detachment

To evaluate the usefulness of anterior segment optical coherence tomography (OCT) in diagnosis, choosing the treatment method, and monitoring the treatment outcomes in Descemet membrane detachment DMD).

We retrospectively reviewed the clinical data for 14 eyes of 13 patients: 8 eyes with DMD after cataract surgery, 2 eyes after deep anterior lamellar keratoplasty (DALK), 2 eyes of 1 patient with Ehlers-Danlos type VI syndrome, 1 eye after contusion, and 1 eye with spontaneous corneal edema of unknown origin. We used OCT to confirm or make the diagnosis, evaluate the configuration of detachment, and monitor treatment results.

DMD was diagnosed in 12 eyes, based on the slit lamp examination. In 2 eyes, because of a very hazy view due to corneal edema, DMD was diagnosed based on OCT findings. We chose the treatment method based on DMD configuration evaluated by OCT examination. Eight eyes were treated conservatively and 6 eyes underwent intracameral air injection with additional ab externo stab incisions. In 12 eyes, Descemet membrane reattached successfully. In 2 eyes of 1 patient with Ehlers-Danlos syndrome, the detachment remained, but corneal thickness had decreased. After anterior chamber air tamponade, we observed the decrease of corneal thickness within 7 days.

OCT is useful in precise evaluation of DMD configuration and choosing the treatment method, but has a very limited role in diagnosis and monitoring the treatment results, where the clinical examination is the most important indicating factor.