Ophthalmology Department, Baba Deep Singh Charitable Hospital, Amritsar, India.
Eye Contact Lens. 2011 Mar;37(2):106-8. doi: 10.1097/ICL.0b013e31820c6fe7.
Descemet membrane detachment (DMD) during phacoemulsification is a well-known complication. Although most of the DMDs resolve on their own, some may require surgical intervention in the form of intracameral injection of air or isoexpansive gas. We report the occurrence and subsequent management of a patient with DMD caused by the leading haptic of a foldable intraocular lens (IOL) during its insertion.
A 50-year-old woman underwent coaxial phacoemulsification for age-related cataract in her right eye. Descemet membrane detachment was noted during the insertion of the foldable posterior chamber IOL through a temporal 2.2-mm incision. Corneal edema did not resolve by the third postoperative day. Scheimpflug photography demonstrated a complete separation between the posterior stroma and DM along the entirety of the cornea. Surgical intervention was performed on the fourth postoperative day, which involved creation of stab incisions into the pre-Descemet space along with intracameral air injection.
Successful apposition of the DM followed by clearing of corneal edema was observed within 1 week.
Our case report highlights the potential complication of DM detachment during insertion of foldable IOL. We performed stab incisions in the pre-DM space to achieve quick and successful repositioning of the detached DM with favorable results.
在超声乳化白内障吸除术中发生的后弹力层脱离（DMD）是一种众所周知的并发症。尽管大多数 DMD 可自行缓解，但有些可能需要通过在眼内注射空气或等张气体的方式进行手术干预。我们报告了 1 例因折叠式人工晶状体（IOL）襻在插入时引起的 DMD 的发生及后续处理。
1 名 50 岁女性因年龄相关性白内障接受了右眼同轴超声乳化白内障吸除术。在通过颞侧 2.2mm 切口插入折叠式后房 IOL 时，发现后弹力层脱离。术后第 3 天，角膜水肿仍未消退。Scheimpflug 摄影显示，角膜的整个后基质和 DM 完全分离。在术后第 4 天行手术干预，在前弹力层空间行刺切术，并向眼内注入空气。
在 1 周内观察到 DM 成功贴合，角膜水肿消退。
我们的病例报告强调了在折叠式 IOL 插入过程中发生 DMD 脱离的潜在并发症。我们在前弹力层空间行刺切术，快速成功地重新定位了脱离的 DM，取得了良好的效果。
