scholarly journals The role of Descemet’s membrane in the pathogeny of corneal edema following anterior segment surgery

2014 ◽  
Vol 73 (5) ◽  
Author(s):  
Karine Feitosa Ximenes ◽  
Jailton Vieira Silva ◽  
Karla Feitosa Ximenes Vasconcelos ◽  
Fernando Queiroz Monte
Keyword(s):  
Anterior Segment ◽  
Corneal Edema ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Anterior Segment Surgery

scholarly journals Successful Treatment of Post-Phacoemulsification Descemet’s Membrane Detachment Assessed by Anterior Segment Optical Coherence Tomography: A Case Report

2021 ◽  
pp. 611-615
Author(s):  
Ayaka Doi ◽  
Tadamichi Akagi ◽  
Akitaka Tsujikawa
Keyword(s):  
Optical Coherence Tomography ◽  
Sulfur Hexafluoride ◽  
Anterior Segment ◽  
Corneal Edema ◽  
Optical Coherence ◽  
Descemet’S Membrane Detachment ◽  
Intracameral Injection ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
The Right

Descemet’s membrane detachment (DMD) is a rare but serious complication of phacoemulsification surgery. A small DMD may resolve spontaneously, but extensive DMD often requires intracameral injection of air, nonexpansile gases, or expansile gases. A 92-year-old man who underwent phacoemulsification and aspiration with intraocular lens placement in the right eye had significantly reduced visual acuity, with a hazy cornea after surgery. Anterior segment optical coherence tomography (AS-OCT) examination revealed extensive DMD throughout the cornea. He was treated with intracameral injection of 20% sulfur hexafluoride. As a result, the Descemet membrane was successfully reattached, and the corneal edema resolved. AS-OCT was helpful in confirming the presence and extent of DMD, provided useful information to determine the appropriate treatment, and was useful for monitoring DMD.

scholarly journals Corneal pachymetry by AS-OCT after Descemet’s membrane endothelial keratoplasty

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Friso G. Heslinga ◽  
Ruben T. Lucassen ◽  
Myrthe A. van den Berg ◽  
Luuk van der Hoek ◽  
Josien P. W. Pluim ◽  
...  
Keyword(s):  
Deep Learning ◽  
Endothelial Function ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Anatomical Landmarks ◽  
Endothelial Keratoplasty ◽  
Descemet’S Membrane Endothelial Keratoplasty ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Thickness Measurements

AbstractCorneal thickness (pachymetry) maps can be used to monitor restoration of corneal endothelial function, for example after Descemet’s membrane endothelial keratoplasty (DMEK). Automated delineation of the corneal interfaces in anterior segment optical coherence tomography (AS-OCT) can be challenging for corneas that are irregularly shaped due to pathology, or as a consequence of surgery, leading to incorrect thickness measurements. In this research, deep learning is used to automatically delineate the corneal interfaces and measure corneal thickness with high accuracy in post-DMEK AS-OCT B-scans. Three different deep learning strategies were developed based on 960 B-scans from 50 patients. On an independent test set of 320 B-scans, corneal thickness could be measured with an error of 13.98 to 15.50 μm for the central 9 mm range, which is less than 3% of the average corneal thickness. The accurate thickness measurements were used to construct detailed pachymetry maps. Moreover, follow-up scans could be registered based on anatomical landmarks to obtain differential pachymetry maps. These maps may enable a more comprehensive understanding of the restoration of the endothelial function after DMEK, where thickness often varies throughout different regions of the cornea, and subsequently contribute to a standardized postoperative regime.

Descemet’s Membrane Detachment

2013 ◽  
Author(s):  
Malik Y. Kahook
Keyword(s):  
Surgical Intervention ◽  
Corneal Stroma ◽  
Corneal Edema ◽  
Glaucoma Surgery ◽  
Bullous Keratopathy ◽  
Descemet’S Membrane Detachment ◽  
Descemet's Membrane ◽  
Central Regions ◽  
Descemet’S Membrane ◽  
Mechanical Manipulation

Corneal injury resulting from glaucoma surgery has been well described. Causes of injury can range from direct mechanical manipulation to the often more subtle pharmacologically induced injuries that occur with use of antifibrotic medications. Descemet’s membrane detachment (DMD) occurs uncommonly during or after intraocular surgery and has been linked with a variety of procedures ranging from simple clear cornea cataract extraction to deep lamellar keratoplasty. The corneal endothelium, which rests upon Descemet’s membrane, functions as a pump to keep the stroma from becoming swollen. Therefore, DMD results in focal corneal edema and possibly bullous keratopathy. If detachment of Descemet’s membrane extends far enough centrally, visual acuity may become sufficiently compromised to necessitate corneal transplantation surgery (either full-thickness penetrating keratoplasty [PKP] or Descemet’s stripping with automated endothelial keratoplasty [DSAEK]). In glaucoma surgery, DMD often results from the mechanical manipulation that occurs with creation of the cornealtrabecular meshwork opening. Knowing how to accurately diagnose and treat DMD can prevent disastrous consequences and preserve vision. Mackool and Holtz proposed separating DMD into 2 categories, planar and nonplanar, depending on the distance of separation between Descemet’s membrane and the posterior corneal stroma. Planar DMD involves less than 1 mm separation of Descemet’s membrane from the corneal stroma and may be limited to the periphery or extend from the periphery to central regions. Nonplanar DMD involves greater than 1 mm separation of Descemet’s membrane from the corneal stroma and may also be categorized as limited to the periphery or extending to central regions. The significance of this classification was the belief that planar DMD was more likely to spontaneously resolve while nonplanar DMD required surgical intervention. Assia and colleagues also split DMD into 2 categories: DMD with scrolling of tissue and DMD without scrolling of tissue. They believed this classification more accurately described potential for spontaneous resolution in that nonscrolled DMD was more likely to resolve without surgical intervention, even if its location was >1mm from the posterior corneal stroma. While useful as a general guide, these classification systems are not foolproof, and each case of DMD should be viewed independently.

scholarly journals Ocular Toxicity Secondary toAsclepias physocarpa: The Balloon Plant

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Susana Pina ◽  
Catarina Pedrosa ◽  
Cristina Santos ◽  
Bernardo Feijóo ◽  
Peter Pego ◽  
...  
Keyword(s):  
Corneal Edema ◽  
Specular Microscopy ◽  
Ocular Toxicity ◽  
Conjunctival Hyperemia ◽  
Blurred Vision ◽  
Ocular Irritation ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
The Right

We report a case of a 65-year-old woman with symptoms of blurred vision and ocular irritation a few hours after accidental contact of the right eye withAsclepias physocarpamilky latex. Observation showed a diffuse conjunctival hyperemia and stromal corneal edema with Descemet’s membrane folds. Recovery was fast and apparently complete in less than one month. However, specular microscopy at 6-months follow-up showed an abnormal endothelial morphology as sequelae, suggesting this condition is not as innocuous as it has been suggested.

scholarly journals Terrien’s Marginal Degeneration with Hydrops

2021 ◽  
Vol 8 (3) ◽  
pp. 1-3
Author(s):  
Anirudh Duhan ◽  
◽  
Eswar Sakare ◽  
Sudhakar Potti ◽  
Madhuri Venigalla ◽  
...  
Keyword(s):  
Corneal Edema ◽  
Descemet's Membrane ◽  
Descemet’S Membrane

We report a case of bilateral Terrien’s Marginal Degeneration with Hydrops. A 59 year old man presented with dimunition of vision in both eyes since 3 years. On examination both eyes had superior ectatic changes with right eye having scarred Descemet’s membrane indicating a healed hydrops and left eye showing superior corneal edema indicating resolving hydrops.

scholarly journals Evaluation of Descemet’s Membrane Detachment Using Anterior Segment Optical Coherence Tomography

2014 ◽  
Vol 44 (5) ◽  
pp. 407-409
Author(s):  
Halil Hüseyin Çağatay ◽  
Metin Ekinci ◽  
Yaran Koban ◽  
Hüseyin Çelik ◽  
Mehmet Ersin Oba
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Descemet’S Membrane Detachment ◽  
Descemet's Membrane ◽  
Descemet’S Membrane

scholarly journals 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

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
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.

scholarly journals Ultrabiomicroscopy Anterior Segment Evaluation of Ocular Contusive Trauma Caused by Pressurized Bottled Drink Caps: A Case Report

2018 ◽  
Vol 9 (2) ◽  
pp. 365-368
Author(s):  
Raffaele Antonio Esposito ◽  
Alessandra Rosati ◽  
Giuseppe Mannino ◽  
Gianluca Scuderi
Keyword(s):  
Emergency Department ◽  
Visual Acuity ◽  
Case Report ◽  
Anterior Segment ◽  
Endothelial Damage ◽  
Sparkling Wine ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Wine Bottle

We report the case of a patient presented to the emergency department because of a contusive trauma from a pressurized bottled drink cap. During the visit, the patient indicated that he had been hit in his left eye by a cork while he was opening a sparkling wine bottle. He underwent a total ophthalmology examination. He had an important reduction of visual acuity, corneal swelling, Descemet’s folds, and hyphema. Therefore, we decided to perform ultrabiomicroscopy (UBM) of the anterior segment to study the endothelial damage and Descemet’s membrane. UBM images confirmed the direct biomicroscopy, highlighting the damaged location.

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