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Anterior Segment–OCT Guided, Endo-illuminator Assisted Management of Descemet’s Membrane Detachment

Kamaljeet Singh , Kamaljeet Singh , S. P. Singh , Kshama Dwivedi , Jagriti Rana , Sushank A. Bhalerao , Harsh Mathur

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Ophthalmology and Allied Sciences 1(1):p 15-21, January - June 2015. | DOI:

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Abstract

 Objective: To study the anatomic and visual outcomes of descemetopexy in Descemet’s membrane detachment (DMD) after cataract surgery with the help of Anterior Segment –OCT (AS-OCT) and endo-illuminator. Design: A prospective study. Participants: Nineteen eyes of 19 patients. Methods: This study was carried out at Regional Institute of Ophthalmology (M.D. Eye Hospital, Dr. Katju Road, Nakhas Kona, Allahabad, India) after taking permission from ethical committee of M.L.N. Medical College, Allahabad from April 2013 to March 2014. We used Anterior segment OCT (AS-OCT) and endoilluminator in the management of Descemet’s membrane detachment. Descemetopexy was performed with air or 14% isoexpansile perfluoropropane (C3F8) or 20% SF6 gas. Main Outcome Measures: Anatomical (reattachment rates) and functional results (best-corrected visual acuity) were studied. Secondary outcome measures were assessment of surgical complications and association of various factors with final visual outcome. Results: With the help of endo-illuminator and OCT, we treated total 19 patients of Descemet’s membrane detachment following cataract surgery with intra-cameral injection of air (3 patients), perfluoropropane (7 patients) and sulphur hexafluoride (9 patients), figure 2. Out of the 19 patients 13 (68%) patients had final visual acuity between 6/6-6/12 and 6 (32%) patients had final visual acuity between 6/12-6/24, figure 3. Reattachment occurred within 48 hours in 15 patients and after 48 hours in 4 patients. Residual DMD was found in one case in which we re-injected SF6. Conclusion: Anterior Segment Optical Coherence Tomography(OCT) guided, endo-illuminator assisted intra-cameral injection of sulphur hexafluoride (SF6) gas is the best way of management of Descemet’s membrane detachment as compared to intra-cameral injection of air and perfluoropropane (C3F8) gas. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Keywords: Anterior Segment Optical Coherence Tomogram; Descemet’s Membrane Detachment; Descemetopexy; Endo-Illuminator. 

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