title: Incision-Site Descemet Membrane Detachment During and After Phacoemulsification: Risk Factors and Management.
abstract: OBJECTIVE
  To evaluate the occurrence of localized incision-site Descemet membrane detachment (DMD) during and after phacoemulsification and to study its relationship with phacoemulsification parameters.
  
  
  METHODS
  Forty-three, consecutive uneventful cases of phacoemulsification through 2.8-mm clear corneal incision were included in this prospective study. Preoperatively, the grade of cataract was assessed. The phacoemulsification parameters noted were phacoemulsification time, aspiration time, cumulative dissipated energy (CDE), ultrasound time, and total fluid volume. Anterior segment optical coherence tomography (AS-OCT) was performed on postoperative days 1 and 7 to study the course of the incision-site DMD.
  
  
  RESULTS
  Fourteen of 43 cases (32%) showed localized incision-site DMD either intraoperatively or on AS-OCT on the first postoperative day. Of these, nine cases were detected intraoperatively, and six cases were detected on AS-OCT on the first postoperative day. All cases were of planar type and resolved spontaneously. A single case showed a concurrent DMD involving central cornea, which resolved without any surgical intervention. The occurrence of DMD was significantly higher in those with the total ultrasound time greater than 60 sec (P=0.038) (odds ratio: 7.639). The CDE was higher in cases with DMD; however, the result was not statistically significant (P=0.062). Torsional equivalent in level-3, total torsional time, equivalent torsional time, aspiration time, and the total fluid volume were comparable (P>0.05) between cases with and without incision-site DMD.
  
  
  CONCLUSIONS
  Postphacoemulsification incision-site DMD may occur in up to one third of cases and is associated with increase in the total ultrasound time.
authors: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors: Namrata
authors: N
authors: Sharma
authors: Pooja
authors: P
authors: Bandivadekar
authors: Tushar
authors: T
authors: Agarwal
authors: Ritu
authors: R
authors: Shah
authors: Jeewan S
authors: JS
authors: Titiyal
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000601:surgery*; D003886:Descemet Membrane / Q000293:injuries*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D061646:Operative Time; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors