Be careful of the DM!
๐๐ฆ๐ด๐ค๐ฆ๐ฎ๐ฆ๐ต'๐ด ๐๐ฆ๐ฎ๐ฃ๐ณ๐ข๐ฏ๐ฆ ๐๐ฆ๐ต๐ข๐ค๐ฉ๐ฎ๐ฆ๐ฏ๐ตโฃ โฃ
Intraoperative complication during intraocular surgery especially cataract surgery that may lead to corneal decompensationโฃ โฃ
๐๐ฐ๐ด๐ต ๐ค๐ฐ๐ฎ๐ฎ๐ฐ๐ฏ ๐ค๐ข๐ถ๐ด๐ฆ: Mechanical separation near the incision site by an instrument, fluid or viscoelastic substanceโฃ
๐๐ต๐ฉ๐ฆ๐ณ ๐๐ช๐ด๐ฌ ๐ง๐ข๐ค๐ต๐ฐ๐ณ๐ด:โฃ โฃ
โ Shallow ACโฃ
โ Anatomical predispositionโฃ
โ Complicated surgeriesโฃ
โ Blunt bladesโฃ
โ Catching the DM during IOL implantation/ irrigation and aspirationโฃ
โ Congenital glaucomaโฃ
โ Keratoconusโฃ
โฃ ๐๐ฅ๐๐ฌ๐ฌ๐ข๐๐ข๐๐๐ญ๐ข๐จ๐ง:โฃ โฃ
1. ๐๐ข๐ค๐ฌ๐ฐ๐ฐ๐ญ ๐ข๐ฏ๐ฅ ๐๐ฐ๐ญ๐ต๐ป (๐๐ข๐ด๐ฆ๐ฅ ๐ฐ๐ฏ ๐ค๐ญ๐ช๐ฏ๐ช๐ค๐ข๐ญ ๐ฑ๐ณ๐ฆ๐ด๐ฆ๐ฏ๐ต๐ข๐ต๐ช๐ฐ๐ฏ):โฃ โฃ
โ Planar โ < 1mm separation from stroma (can resolve spontaneously)โฃ
โ Non- Planar โ > 1mm separation from stroma (should be repaired early)โฃ โฃ
2. ๐๐ณ. ๐๐ข๐ค๐ฐ๐ฃโ๐ด (๐๐ข๐ด๐ฆ๐ฅ ๐ฐ๐ฏ ๐ฆ๐ต๐ช๐ฐ๐ฑ๐ข๐ต๐ฉ๐ฐ๐จ๐ฆ๐ฏ๐ฆ๐ด๐ช๐ด):โฃ โฃ
โ Stripped DM (during viscoelastic injection or insertion of blunt instruments)โฃ
โ Taut DMโฃ - A long-standing stripped descemetโs membrane detachment could sometimes adhere to intraocular contents with secondary fibrosis, thus turning into a taut descemetโs membrane detachment.โฃ - It could be due to inflammation involving descemet's membrane, secondary incarceration of descemet's membrane in an inflammatory processโฃ โฃ
3. ๐๐ฐ๐ณ๐ฑ๐ฉ๐ฐ๐ญ๐ฐ๐จ๐ช๐ค๐ข๐ญ:โฃ โฃ
โ DMD with non scrolled edgesโฃ
โ DMD with scrolled edgesโฃ โฃ
๐๐ฅ๐ข๐ญ ๐๐๐ฆ๐ฉ ๐๐ฑ๐๐ฆ๐ข๐ง๐๐ญ๐ข๐จ๐ง:โฃ โฃ
Diffuse corneal edema can be presentโฃ โฃ
๐๐ฆ๐๐ ๐ข๐ง๐ :โฃ โฃ
Anterior Segment OCT โฃ
Ultrasound Biomicroscopy (UBM)โฃ โฃ
๐๐๐ง๐๐ ๐๐ฆ๐๐ง๐ญ:โฃ โฃ
โ Conservative โ Topical steroids, Hyperosmotic agentsโฃ โฃ
โ Surgical โโฃ
a. Internal Tamponade with airโฃ
b. Descemetopexy with C3F8 and SF6โฃ
c. Transcorneal suturingโฃ
d. Descemetotomyโฃ
e. Endothelial/ Penetrating Keratoplastyโฃ โฃ
Image from Rajan Eye Care Hospital
#cornea #ocularsurface #dmd #descemetmembranedetachment
