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Stripping of Descemet's membrane: a clinicopathologic correlation
D Pieramici1, W R Green, W J Stark
1Eye Pathology Laboratory, Johns Hopkins University Medical Institutions, Baltimore, MD.
Ophthalmic Surgery
|April 1, 1994
Summary
Accidental sodium hyaluronate injection can cause Descemet
Area of Science:
- Ophthalmology
- Corneal Surgery
- Histopathology
Background:
- Descemet's membrane detachment is a rare complication.
- Intraocular surgery is a known risk factor for ocular complications.
Observation:
- A case of accidental sodium hyaluronate (Healon) injection anterior to Descemet's membrane resulted in near-complete detachment.
- Histopathology confirmed sodium hyaluronate globules between the posterior stroma and Descemet's membrane.
- Review of 111 cases revealed intraocular surgery (80%) as a major predisposing factor.
Findings:
- Cataract surgery was the most frequent prior intraocular surgery (58%).
- Associated corneal pathologies included bullous keratopathy (43%) and scarring/vascularization (29.7%).
- Sodium hyaluronate injection following anterior chamber reformation was implicated in one case of 90% detachment.
Implications:
- Intraocular surgery is a significant risk factor for Descemet's membrane detachment.
- Pre-existing corneal pathologies may obscure clinical diagnosis.
- Careful technique during anterior chamber manipulation is crucial to prevent this complication.