Descemet's Membrane Detachment Following Phacoemulsification

BACKGROUND AND OBJECTIVE: To determine the management options and the indications for surgical intervention in Descemet's membrane detachment (DMD) after phacoemulsification. PATIENTS AND METHODS: Clinical records of 11 consecutive eyes (11 patients) with DMD were reviewed. All cases had undergone phacoemulsification with posterior chamber intraocular lens implantation. Patients with DMD involving one-third or more of the cornea were analyzed. RESULTS: All patients underwent clear corneal phacoemulsification. In three cases where the detachment was recognized intraoperatively, perfluoropropane gas was injected. Eight eyes (8 cases) had unexpected corneal edema detected as DMD postoperatively and managed by injecting perfluoropropane gas into the anterior chamber. Three eyes that required repeated surgical intervention postoperatively had more than 50% corneal involvement with significant separation of the membrane from the stroma and curling or folding of the membrane. At last follow-up, 10 eyes retained clear corneas and one had residual DMD not involving visual axis. All 11 eyes had best-corrected visual acuity of better than 6/12. CONCLUSION: DMD should be suspected in patients showing unexpected corneal edema postoperatively who have undergone uneventful phacoemulsification and be treated in a timely manner. Surgical intervention is recommended in cases with significant separation of the membrane from stroma and curling or folding of the Descemet's membrane.