Treatment of Refractory Descemet Membrane Detachment via Repeat Descemetopexy: A Case Report.
Jia'nan Xie, Wei Xie, Liangliang Zhao
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Case in brief
An 82-year-old man with age-related cataract and a history of bilateral pterygium surgery with corneal scarring developed Descemet membrane detachment during phacoemulsification and intraocular lens implantation. Initial intracameral air injection did not achieve stable reattachment. Slit-lamp examination and anterior segment optical coherence tomography showed persistent and recurrent detachment with stromal edema. Two further procedures used air injection and mechanical repositioning, with the injection site and direction guided by imaging. After the final intervention, the membrane was fully reattached, corneal transparency returned, and visual acuity improved to 0.3 at 1-month follow-up.
What made this case unusual
The detachment remained refractory after initial air injection and recurred, requiring repeat procedures tailored to its imaging-defined size, location, and configuration.
Diagnostic / clinical pearl
For persistent or recurrent Descemet membrane detachment, anterior segment optical coherence tomography can guide the direction and site of air injection; mechanical repositioning may also be needed.
Why it matters
The authors suggest prior pterygium surgery and corneal scarring may increase the risk of persistent detachment after phacoemulsification.