title: Management of Descemet Membrane Detachment After Forceps Birth Injury.
abstract: OBJECTIVE
  To describe the clinical signs of Descemet membrane (DM) detachment due to forceps-related birth injury and its subsequent management using optical coherence tomography.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 3-day-old term infant presented with left eye corneal clouding and a definitive history of traumatic forceps-assisted delivery. Despite topical therapy, corneal clouding persisted, necessitating an examination under anesthesia using ultrasound and handheld optical coherence tomography. This revealed not only a tear in DM but also a large detachment. Injection of air alone failed to achieve apposition of DM to the posterior stroma. Apposition was achieved only after penetration of the overlying cornea with the needle of a 10-0 nylon suture and release of clear viscous fluid. The cornea cleared within the first week and continued in the months to follow.
  
  
  CONCLUSIONS
  Prolonged corneal edema should alert the physician to probable DM detachment after forceps-related birth injury. Injecting air alone may not be sufficient to reattach the detached DM.
authors.affiliation: *Children's Eye Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA; and †Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Swarupa
authors.initials: S
authors.lastname: Kancherla
authors.forename: Ann
authors.initials: A
authors.lastname: Shue
authors.forename: Mohammad Faizan
authors.initials: MF
authors.lastname: Pathan
authors.forename: Christin L
authors.initials: CL
authors.lastname: Sylvester
authors.forename: Ken K
authors.initials: KK
authors.lastname: Nischal
mesh_terms: D001720:Birth Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D015715:Corneal Edema / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003318:Corneal Opacity / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003886:Descemet Membrane / Q000000981:diagnostic imaging / Q000293:injuries*; D005131:Eye Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009772:Obstetrical Forceps / Q000009:adverse effects*; D013508:Ophthalmologic Surgical Procedures; D041623:Tomography, Optical Coherence