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Descemet Membrane Detachment in Femtosecond Laser-Assisted Cataract Surgery
Ricardo M Nosé1, Maria Daniela Rivera-Monge, Adriana S Forseto
1*Eye Clinic Day Hospital, São Paulo, Brazil; †Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, São Paulo, Brazil; and ‡Sorocaba Ophthalmologic Hospital-Sorocaba Eye Bank, Sorocaba, Brazil.
Purpose:
To report a case series of 4 patients with Descemet membrane detachment (DMD) after undergoing femtosecond laser-assisted cataract surgery incisions.
Methods:
Case report.
Results:
DMD was noted at the secondary incision (n = 2) or at the main incision (n = 2). All the secondary incision and 1 main incision DMD were resolved with intraoperative maneuvers. Delay in recognizing DMD intraoperatively at the principal incision in 1 case led to inadvertent aspiration of a part of it and persistent postoperative corneal edema. This complication was handled with Descemet membrane endothelial keratoplasty 1 month after initial surgery.
Conclusions:
DMD can occur after femtosecond laser-assisted cataract surgery, although it is a rare complication as it is in traditional phacoemulsification. The surgeon must be prepared to recognize it, manage it intraoperatively, and treat it postoperatively to reduce the risk of permanent damage to the eye.
Insights
Descemet membrane detachment (DMD) is a rare complication following femtosecond laser-assisted cataract surgery. Prompt recognition and intraoperative management are crucial to prevent persistent corneal edema and potential vision loss.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Corneal Surgery
Background:
- Femtosecond laser-assisted cataract surgery (FLACS) offers precision but carries potential complications.
- Descemet membrane detachment (DMD) is a known, albeit rare, complication in cataract surgery.
- Understanding DMD incidence and management after FLACS is essential for surgical safety.
Observation:
- A case series of 4 patients experiencing DMD after FLACS is presented.
- DMD occurred at both main and secondary incisions.
- Two cases involved secondary incisions, and two involved the main incision.
Findings:
- Intraoperative management resolved DMD in most cases (3 out of 4).
- Delayed recognition at the main incision led to inadvertent tissue aspiration and persistent corneal edema.
- One severe case required Descemet membrane endothelial keratoplasty (DMEK) for resolution.
Implications:
- Surgeons must be vigilant for DMD following FLACS.
- Prompt intraoperative recognition and management of DMD are critical.
- Effective management strategies can mitigate the risk of long-term visual impairment from FLACS-associated DMD.
