A 60-year-old lady underwent an uncomplicated extracapsular cataract extraction (ECCE). On first post-op day, she had a vision of 20/200 with edema on superior 1/3rd of cornea. Slit-lamp examination revealed localized stromal edema with Descemet's membrane folds in main incision area reaching upper border of pupil [Fig. 1a]. It was assumed that the edema was due to Descemet's Membrane Detachment (DMD). After 1 week, edema had slightly decreased with an improvement in visual acuity to 20/40 after administration of topical prednisolone-acetate 1% and sodium chloride 5%. On repeat slit-lamp examination, a refractile membrane with a well-defined margin was seen closely adhered to the endothelium [Fig. 1b]. UBM showed a separate membrane lying almost clinging to the endothelium, but no detachment of descent's membrane was identified [Fig. 1c]. Hence, what was assumed to be DMD turned out to be a retained anterior capsule. After the removal of anterior capsule in OT, edema subsided within a week with BCVA 20/30 [Fig. 1d]. Thus, though DMD remains one of the commonest complications[1] and causes of persistent corneal edema post-cataract surgery, it remains important for us to look for any other possible cause responsible for the condition. With the new imaging modalities[2] like AS-OCT and UBM, the detection of the pathology causing post-op corneal edema has become easier.
Figure 1.
Slit lamp photograph showing (a) Corneal edema in upper part of cornea. (b) refractile membrane with a well-defined margin closely adhered to the endothelium. (c) UBM showing a separate membrane lying almost clinging to the endothelium, but no detachment of descemet's membrane identified. (d) Slit lamp photograph showing decrease in edema with improvement in vision
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References
- 1.Mulhern M, Barry P, Condon P. A case of Descemet's membrane detachment during phacoemulsification surgery. Br J Ophthalmol. 1996;80:185–6. doi: 10.1136/bjo.80.2.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Guo P, Pan Y, Zhang Y, Tighe S, Zhu Y, Li M, et al. Study on the classification of Descemet membrane detachment after cataract surgery with AS-OCT. Int J Med Sci. 2018;15:1092–7. doi: 10.7150/ijms.26972. [DOI] [PMC free article] [PubMed] [Google Scholar]