Baráková Drahomíra, Darsová Denisa
Gemini Eye Clinic a.s., Prague, Czech Republic.
Department of Ophthalmology, Second Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic.
Int Med Case Rep J. 2021 Feb 3;14:45-49. doi: 10.2147/IMCRJ.S290179. eCollection 2021.
To demonstrate an unusual mechanism of iatrogenic, central descemetorhexis (DMR) during cataract surgery and subsequent rare spontaneous visual acuity improvement within 2 months after inadvertent surgical complication.
A 81 year old woman underwent cataract surgery complicated by the loss of a 4.8X4.75 mm diameter central area of Descemet membrane. Perioperative video recording documented the DMR formation during continuous curvilinear capsulorhexis creation.
Postoperatively, severe corneal edema with folds in the remaining Descemet membrane were observed. The patient was managed conservatively. The corneal edema gradually resolved over 2 months with improving of visual acuity from counting fingers to 20/20.
Unlike Descemet membrane detachment, descemetorhexis is a rare complication after intraocular surgery. The case report identifies a previously unknown mechanism of DMR formation during anterior capsulotomy creation. Loss of Descemet membrane may be managed conservatively in an otherwise healthy cornea with good final visual outcome without the need for surgical intervention.
证明白内障手术期间医源性中央后弹力层脱离（DMR）的一种不寻常机制，以及在意外手术并发症发生后2个月内罕见的自发视力改善情况。
一名81岁女性接受白内障手术，术中出现直径4.8×4.75mm的中央后弹力层区域缺失。围手术期视频记录显示在连续环形撕囊过程中DMR形成。
术后观察到严重角膜水肿，剩余后弹力层出现褶皱。对患者进行保守治疗。角膜水肿在2个月内逐渐消退，视力从数指提高到20/20。
与后弹力层脱离不同，后弹力层撕脱是眼内手术后罕见的并发症。该病例报告确定了前囊切开术中DMR形成的一种此前未知的机制。在其他方面健康的角膜中，后弹力层缺失可通过保守治疗，最终获得良好的视力结果，无需手术干预。
