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Optical coherence tomography-guided intracameral air injection for treatment of extensive Descemet's membrane detachment

Extensive Descemet's membrane detachment (DMD) is a rare but potentially serious complication of cataract surgery.1 Sometimes, the diagnosis may be difficult because corneal oedema can obscure visualisation of the Descemet's membrane.2 If a larger or more progressive detachment results in corneal opacification and is responsible for loss of vision, many doctors have favoured early surgical intervention.3

In this report, we describe a method of anterior segment optical coherence tomography (OCT)-guided aqueous fluid drainage and intracameral air injection for treatment of DMD in three patients.

Three patients, who had cataract extraction with intra-ocular lens implantation, were referred to us from three other hospitals. Case 1 (a 70-year-old man) had received manual uneventful small incision cataract surgery 15 days earlier. Case 2 (a 64–year-old man) had clear corneal phacoemulsification for treatment of acute primary closed angle glaucoma combined with intumescent cataract. The surgeon realised the occurrence of DMD at the first day after surgery and intracameral air was injected partially ﬁlling the anterior chamber. On the fourth postoperative day, corneal oedema became more generalised. Case 3 (a 71-year-old man) had clear corneal phacoemulsification …