The authors describe a novel protocol for managing post-phacoemulsification Descemet membrane detachment, offering guidelines for differentiating surgical and medical intervention.
This is the first report detailing successful management of Descemet membrane detachment in terms of its height, extent, length, and relation to the pupil (HELP), which was measured using anterior segment OCT.
Of 161 study eyes, 95 eyes, those with larger, more central detachments, were assigned to the surgical intervention group. Surgery consisted of treatment with intracameral gas, 20% sulfur hexafluoride or sterile air injection. Sixty-five eyes with smaller, more peripheral detachments were treated with topical hyperosmotic agent, prednisolone acetate and ofloxacin.
More than 95% of patients in both groups achieved membrane reattachment. Visual acuity was also comparable between treatment groups, with more than 80% achieving CDVA of 20/40 or better. In particular, the authors showed that central but small detachments can be managed conservatively without surgical intervention yet still achieve reattachment. The number of patients with central involvement, however, was limited.
The authors note that this study was limited to cases of early postoperative Descemet membrane detachment and might not be useful for managing chronic or tractional Descemet membrane detachments associated with inflammation.