Descemet's membrane detachment after cataract surgery: management and outcome.
OBJECTIVE
To analyze the possible causes of Descemet's membrane detachment (DMD) and the treatment and outcome of patients after cataract surgery.


METHODS
Retrospective noncomparative interventional case series.


METHODS
Fifteen eyes of 12 patients.


METHODS
We reviewed clinical data on 15 eyes of 12 patients with nonscrolled DMD after cataract surgery who presented to the Cornea Service at Wills Eye Hospital from 1986 to 2001. Institutional review board/ethics committee approval was obtained.


METHODS
Visual acuity and reattachment of Descemet's membrane.


RESULTS
Cataract procedures involved nine clear-corneal eyes, four limbal incisions, one trabeculectomy/combined phacoemulsification, and one extracapsular cataract extraction. From 1986 to 1990, we had 1 patient; from 1991 to 1995, no patients; and from 1996 to 2001, 11 patients (including all clear-corneal eyes). Of the 15 eyes, 8 resolved with medical treatment alone, with a mean time to resolution of 9.8 weeks. One patient was lost to follow-up while improving on medical treatment, and another required a penetrating keratoplasty (PK) after medical treatment failed. Five eyes received anterior-chamber SF(6) gas injection. Of these eyes, three DMDs resolved, one underwent repeated injection (not improving after 10 weeks), and another required a PK.


CONCLUSIONS
Referrals for DMD seem to be increasing. This may be explained by the increase in clear-corneal cataract procedures. Medical treatment seems to be adequate in many cases and may be appropriate initial therapy. When needed, SF(6) gas injection may also be successful, but not in all cases.
Marcon
Alexandre S
AS
Cornea Service, Wills Eye Hospital, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Rapuano
Christopher J
CJ
Jones
Matthew R
MR
Laibson
Peter R
PR
Cohen
Elisabeth J
EJ
D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000187:drug effects; D002387:Cataract Extraction / Q000009:adverse effects*; D003316:Corneal Diseases / Q000209:etiology / Q000628:therapy*; D003886:Descemet Membrane / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000628:therapy; D011239:Prednisolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000627:therapeutic use; D013459:Sulfur Hexafluoride / Q000627:therapeutic use; D016896:Treatment Outcome; D014792:Visual Acuity
D005938:Glucocorticoids; D012965:Sodium Chloride; C009935:prednisolone acetate; D011239:Prednisolone; D013459:Sulfur Hexafluoride