AN ANALYTICAL STUDY TO IDENTIFY THE RISK FACTORS ASSOCIATED WITH DESCEMET'S MEMBRANE DETACHMENT IN PATIENTS UNDERGOING CATARACT SURGERY

Abstract

Background

Descemet’s membrane detachment (DMD) or tears may occur as a complication of intraocular procedures. The aim of this study was to analyze the risk factors predisposing to Descemet’s Membrane Detachment during conventional small incision cataract surgery and also to determine the association of these risk factors to final visual outcome after pneumodescemetopexy.

Methods

A prospective observational study was conducted on 40 patients who had developed DMD following small incision cataract surgery. Complete ophthalmic examination was done using slitlamp biomicroscopy, Pachymetry, ultrasound biomicroscopy and AS-OCT. In all patients in whom DMD was documented and classified, descemetopexy was performed using intracameral air with a standard technique. The anatomic outcome was defined as complete reattachment of Descemet membrane and the functional outcome was defined as the increase in BCVA and a decrease in corneal edema. Student’s ‘t’ test and Chi square test were used to test the significance of difference between quantitative variables.

Results

The mean age of the patients was 63.97+/-7.66. About 47.5% of them were in the age group of 61-70 yrs. There was no specific sexual preponderance. Risk factors like Brown cataract (p<0.001) and pseudoexfoliation (p <0.009) had more significant association with DMD. The mean pretreatment and post treatment CCT were 717.3μm and 528.4μm respectively (p value < 0.001). At one month follow-up, the logMAR visual acuity improved significantly from 1.7±0.44 to 0.45±0.12. This study showed that more severe the DMD, the poorer will be the final visual outcome. (p < 0.001).

Conclusion

Early surgical intervention, even in cases with small Descemet membrane detachments, by pneumodescemetopexy was associated with a satisfactory final anatomical and visual outcome.