A Simple Repair Algorithm for Descemet's Membrane Detachment Performed at the Slit Lamp

Area of Science:

• Ophthalmology
• Corneal Surgery
• Anterior Segment Surgery

Background:

• Descemet's membrane detachment (DMD) can cause persistent corneal edema after phacoemulsification.
• Conservative treatments are often ineffective for significant DMD.

Purpose of the Study:

• To investigate a simple, safe, and effective repair algorithm for Descemet's membrane detachment (DMD).
• To evaluate the efficacy of Pentacam and anterior segment optical coherence tomography (AS-OCT) in delineating DMD.
• To assess visual outcomes and complications following the repair procedure.

Main Methods:

• Retrospective study of 12 patients with persistent corneal edema due to DMD.
• Delineation of DMD using Pentacam and AS-OCT.
• Repair involved paracentesis and intracameral air injection, followed by supine positioning.
• Outcomes assessed included DM reattachment, visual acuity, and complications at one month.

Main Results:

• Complete reattachment of Descemet's membrane and corneal clarity were achieved in all 12 eyes.
• 91.7% of eyes required only one repair procedure.
• No major adverse events were recorded; one eye experienced temporary increased intraocular pressure.

Conclusions:

• A simplified, outpatient repair algorithm for DMD, guided by Pentacam and AS-OCT, is safe and effective.
• This approach facilitates timely diagnosis, evaluation, and management of DMD.
• The algorithm shows promise for improving visual outcomes in patients with post-phacoemulsification DMD.