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OPHTHALMIC IMAGE
Year : 2022  |  Volume : 2  |  Issue : 2  |  Page : 610

Double anterior chamber or descemet membrane detachment - Why and how to distinguish?


1 Department of Cornea and Refractive Surgery, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
2 Department of Optometry, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India

Date of Web Publication13-Apr-2022

Correspondence Address:
Radhika Natarajan
Sankara Nethralaya, Medical Research Foundation, 41, College Road, Chennai - 600 006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1936_21

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How to cite this article:
Ravichandran S, Natarajan R, Janarthanam JB. Double anterior chamber or descemet membrane detachment - Why and how to distinguish?. Indian J Ophthalmol Case Rep 2022;2:610

How to cite this URL:
Ravichandran S, Natarajan R, Janarthanam JB. Double anterior chamber or descemet membrane detachment - Why and how to distinguish?. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 May 18];2:610. Available from: https://www.ijoreports.in/text.asp?2022/2/2/610/342913



A membrane posterior to a penetrating corneal graft could be Descemet's membrane detachment (DMD), retained host Descemet's membrane (DM), or inflammatory retro-corneal membrane. A flimsy, translucent inferior retro-graft membrane of 4–5-mm height was noted, on the second postoperative day, suspicious of DMD [Figure 1]a.
Figure 1: (a) Slit picture of membrane (yellow arrowheads) behind the graft on the second postoperative day. (b) AS-OCT showing membrane (yellow arrowheads) 3 mm away from graft by cursor measurement. Bright reflex of intact graft Descemet's membrane also seen (pink arrowheads). (c) Fibrosed membrane (yellow arrowheads) with clear overlying graft at 2 months follow up. (d) Thickened membrane on AS-OCT at 2 months follow-up

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However, it was taut, distant from overlying graft on anterior segment optical coherence tomography (AS-OCT) with graft compact, suggestive of retained host DM due to incomplete trephination [Figure 1]b.[1] The membrane later thickened and fibrosed at 8 weeks [Figure 1]c and [Figure 1]d.[2]

The distinction is important as DMD needs repair to avoid decompensation while retained DM can be watched for complications.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Chen YP, Lai PC, Chen PY, Lin KK, Hsiao CH. Retained descemet's membrane after penetrating keratoplasty. J Cataract Refract Surg 2003;29:1842-4.  Back to cited text no. 1
    
2.
Thyagarajan S, Mearza AA, Falcon MG. Inadvertent retention of descemet membrane in penetrating keratoplasty. Cornea 2006;25:748-9.  Back to cited text no. 2
    


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