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DMD!




-After the lens vesicle separates from the surface epithelium, a wave of mesenchyme forms the primary corneal stroma.

-A second wave then forms the endothelium, which secretes the DM.

-The DM, hence, has a potential plane of separation from the corneal stroma, which we use to our benefit in DMEK surgery and which works against us in an inadvertent DM detachment.


ASSESSING THE DMD:

-Must be suspected when unexpected corneal edema is noted on the day after surgery.

-In the presence of significant edema, it is not unusual for an underlying DMD to be missed unless specifically looked for.

-If suspected, dilating the pupil may help, as some of the features of a DMD may be better seen on retro illumination against the red fundal glow seen in a dilated pupil.


SWIPE TO SEE A FEW CLASSIFICATIONS OF DMD.


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Image from Rajan Eye Care Hospital⁣

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