Anterior Segment Optical Coherence Tomography-Guided Management Algorithm for Descemet Membrane Detachment After...

Area of Science:

• Ophthalmology
• Medical Imaging

Background:

• Persistent corneal edema after intraocular surgery can indicate Descemet membrane detachment (DMD).
• Standard medical therapy is often ineffective for these cases.

Purpose of the Study:

• To assess the utility of anterior segment optical coherence tomography (ASOCT) in identifying and managing Descemet membrane detachment (DMD).
• To introduce and evaluate a novel ASOCT-guided algorithm for treating DMD-related corneal edema.

Main Methods:

• ASOCT was performed on 37 patients with persistent corneal edema unresponsive to medical therapy.
• A treatment algorithm based on DMD location and morphology (planar vs. scrolled edges) guided intracameral injections of air or 14% perfluoropropane (C3F8).

Main Results:

• ASOCT detected DMD in 25 eyes, with 52% exhibiting scrolled edges and 48% being peripheral.
• Descemetopexy using intracameral air or C3F8 achieved complete resolution of DMD in all treated eyes.
• The average time to resolution was 16.0 ± 7.1 days.

Conclusions:

• ASOCT is a valuable diagnostic tool for characterizing and managing DMD in nonresolving postoperative corneal edema.
• The described algorithm for intracameral gas injection offers a successful alternative to corneal transplantation.