Purpose:
To report a case of a Descemet membrane's (DM) detachment after radial keratotomy (RK).
Methods:
A patient (male) underwent RK (16 cuts) 20 years before referring to the Eye Center of Humanitas (Milan) for a progressive visual loss. The slit-lamp examination showed severe corneal stromal edema and a large DM detachment in the lower half of the cornea. Anterior segment optical coherence tomography (AS-OCT) and endothelial cells count confirmed DM detachment and endothelial cells damage. Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) was planned and topical hypertonic therapy was prescribed before the surgery.
Results:
Eight months later, the patient mentioned a spontaneous increase in visual acuity; the slit-lamp examination and the AS-OCT displayed a recovery of corneal transparency with a resolution of DM detachment.
Conclusions:
This is the first report of spontaneous DM detachment with severe corneal edema after RK. We suggest that hypertonic therapy may reduce DM detachment and restore corneal transparency.