title: Iatrogenic descemetorhexis as a complication of phacoemulsification.
abstract: During clear corneal temporal phacoemulsification, an accidental iatrogenic descemetorhexis occurred. The entire cornea was hazy and edematous on the first postoperative day. By the 1-month postoperative review, the cornea had become clear with visible descemetorhexis margins; best corrected visual acuity was 20/25, and the pachymetry was 556 microm. The patient remained stable at the 2-years postoperative follow-up, and specular microscopy done at this time showed a cell density of 1301 cells/mm2 with evidence of pleomorphism and polymegethism. This is the first report of iatrogenic descemetorhexis in which the cornea had become clear and nonedematous by as early as 1 month postoperatively. This case highlights that a healthy endothelium can maintain corneal deturgescence despite a low endothelial cell count. Corneal thickness increases only when the number of endothelial cells has gone below a physiologic lower limit.
authors.affiliation: Dr. Agarwal's Eye Hospital, Chennai, India. dragarwal@vsnl.com
authors.forename: Amar
authors.initials: A
authors.lastname: Agarwal
authors.forename: Soosan
authors.initials: S
authors.lastname: Jacob
authors.forename: Athiya
authors.initials: A
authors.lastname: Agarwal
authors.forename: Sunitha
authors.initials: S
authors.lastname: Agarwal
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar M
mesh_terms: D000368:Aged; D002452:Cell Count; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D015715:Corneal Edema / Q000209:etiology / Q000503:physiopathology; D003886:Descemet Membrane / Q000473:pathology*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D018918:Phacoemulsification / Q000009:adverse effects*; D014792:Visual Acuity