Spontaneous detachment of Descemet's membrane. Case report and literature review

Detachment of Descemet's membrane is an unusual cause of postoperative corneal edema. The typical detachment is small and usually limited to the area near the limbal wound. These peripheral detachments usually heal without sequelae as endothelium spreads over the area and secretes a new Descemet's membrane. We report an unusual case of spontaneous, extensive central separation of Descemet's membrane occurring 3 weeks following uncomplicated extracapsular cataract extraction with posterior chamber lens implant. Attempted reattachment of the membrane with intracameral air was only partially successful, but 12 weeks later the detachment spontaneously resolved with recovery of vision to 20/30. An anatomic predisposition may be implicated, because the fellow eye exhibits the diffuse thickening of Descemet's membrane. Descemet's detachment is a rare but potentially reversible cause of corneal edema following cataract surgery and should not be confused with early-onset pseudophakic bullous keratopathy.