PMC7718970_01
(A) You can see the separation and detachment of the Descemet membrane. (B) Soft-shell technique was performed to protect the endothelium.
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Intracameral anesthesia was applied, then trypan blue, balanced saline solution (BSS) was placed, and after placing the adaptive viscoelastic, a separation of the descemet membrane was observed greater than at 12 hours and less than at 6 hours Figure 1A. Before the observation of the detachment and to be able to continue with the surgery, the soft-shell technique was performed to protect the corneal endothelium and the descemet membrane, performing a paracentesis at 12 o'clock so that both layers of the descemet membrane were united, and in this way continuous with surgery, performing continuous circular capsulorhexis, and phacoemulsification was continued with low parameters, viscoelastic was placed again to introduce the intraocular lens very delicately Figure 1B.
Descemet s membrane detached in a central and peripheral pendant wavy shape, with stromal edema.
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AS-OCT was requested to show the adhesion of the descemet membrane to the endothelium, a central undulating flap and a hanging flap were noted at the level of the main incision, in addition to stromal edema (height of 350 microns and length of 3 mm in Zone 1 according to HELP algorithm) Figure 2.
(A) In postoperative clear cornea, with gas bubble present. (B) AS -OCT- adhered Descemet membrane.
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Figure 3A. AS-OCT, adhered descemet membrane Figure 3B.
At 8 weeks after gas bubble application, the Descemet membrane remained adhered.
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It was evaluated at 8 weeks with a new AS-OCT and the descemet membrane remained attached Figure 4.