A Comparative Study between Air Bubble Tamponade Alone versus Air Bubble Tamponade with Internal Fluid Aspiration for Nonplanar Descemet’s Membrane Detachment after Phacoemulsification

Purpose. To compare the efficacy of air bubble tamponade alone versus air bubble tamponade with internal fluid aspiration for nonplanar Descemet’s membrane detachment after clear corneal incision phacoemulsification. Methods. This study is a prospective, intervention, comparative randomised clinical trial, conducted at a private eye centre, Ismailia, Egypt, from March 2019 to March 2020. It contained 30 eyes of 24 patients who had postphacoemulsification nonplanar Descemet’s membrane detachment involving the periphery and the central area of the cornea (>50% of the cornea) with corneal oedema. The patients were divided into two groups: group A: patients with nonplanar DMD affecting the central cornea treated by air bubble tamponade only and group B: patients with nonplanar DMD affecting the central cornea treated by air bubble tamponade augmented by internal fluid aspiration. Trial Registration: This trial was registered at www.pactr.org and the identification number for the registry is PACTR202006612296119. Results. During the 12-month study period, this study included 30 eyes (24 patients) out of 1356 phaco surgeries with postphacoemulsification nonplanar Descemet’s membrane detachment. Six patients had DMD in both eyes, eight patients had DMD in the right eye, and ten patients had DMD in the left eye. All patients have successful surgeries without complications. The calculated incidence rate for visually significant DMD was 2.2% per year. The mean ± SD time interval from cataract surgery to the primary intervention was 4.2 ± 1.1 days. Descemet’s membrane was attached in 56.25% of patients in group A (9 out of 16 eyes) and 92.6% of patients in group B (13 out of 14 eyes) with a minimum of one-month follow-up. Conclusion. Air descemetopexy combined with the internal fluid aspiration demonstrated to be more efficient than air descemetopexy only to treat Descemet’s membrane detachment following phacoemulsification. It should be tried before planning other major surgeries in patients with severe Descemet’s membrane detachment.

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Wound Integrity of 2.0 mm Transconjunctival Single-Plane Sclerocorneal Incision: A Comparison between a Motorized Injector with/without Pause Time and a Manual Injector

Journal of Ophthalmology ◽

10.1155/2016/8129298 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Hisanori Imai ◽

Ayaka Fujii ◽

Emiko Tani ◽

Atsushi Azumi

Keyword(s):

Anterior Segment ◽

Pause Time ◽

Intraocular Lens Implantation ◽

Single Plane ◽

Incision Size ◽

Lens Implantation ◽

Descemet's Membrane ◽

Group A ◽

Descemet’S Membrane ◽

Group B

Purpose. To compare the final incision size and wound structure after the intraocular lens implantation from 2.0 mm transconjunctival single-plane sclerocorneal incision (TSSI) between the use of a motorized injector at first speed and the use of a manual injector.Methods. Patients were divided into three groups as follows: Group A, a manual injector, Group B, a motorized injector with 0.5 s pause time, and Group C, a motorized injector without pause time. The change in incision size and anterior segment optical coherence tomography findings of the wound structure were analyzed.Results. 110 eyes were enrolled (Group A: 40, Group B: 30, and Group C: 40). The averaged change in incision size (mm) was 0.08, 0.01, and 0.03 in Groups A, B, and C, respectively (p<0.001). The incision enlargement in Group A was statistically larger compared with other groups (p<0.01). Descemet’s membrane detachments were seen in 26, 9, and 27 eyes one day after the surgery in Groups A, B, and C, respectively (p=0.001). The rate of Descemet’s membrane detachment in Group B was significantly lower than other groups (p<0.01).Conclusions. The use of a motorized injector by fastest setting with 0.5 s pause time is the best for less wound damage in 2.0 mm TSSI.

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Intraoperative Descemet’s membrane detachment in a case of phacomorphic glaucoma

BMJ Case Reports ◽

10.1136/bcr-2018-225593 ◽

2018 ◽

pp. bcr-2018-225593

Author(s):

Amar Pujari ◽

Deepa R Swamy ◽

Manthan Hasmukhbhai Chaniyara ◽

Namrata Sharma

Keyword(s):

Central Corneal Thickness ◽

Corneal Thickness ◽

Gradual Improvement ◽

Replacement Surgery ◽

Central Cornea ◽

Corrected Visual Acuity ◽

Descemet’S Membrane Detachment ◽

Lens Implantation ◽

Descemet's Membrane ◽

Descemet’S Membrane

A 60-year-old female patient with phacomorphic glaucoma underwent initial medical management to control the intraocular pressure (IOP). After 48 hours, a stable IOP was achieved and subsequently the patient was planned for phacoemulsification followed by intraocular lens implantation. There was initial difficulty while reconstructing the corneal wounds; however, phacoemulsification and IOL implantation were uneventful but during viscoelastic removal, an inadvertent Descemet’s membrane detachment involving the central cornea was noted. Postoperatively corneal oedema persisted till 1 week, following which there was a gradual improvement with topical antibiotics, steroids and hyperosmotic agents. At the end of 6 months, the best corrected visual acuity was 20/25 with a central corneal thickness of 580 µm without any need for additional endothelial replacement surgery.

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