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Results for “Descemet Membrane”

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At least 19 recordsLinked to original sources
PubMed2006

Technique for preparation of the corneal endothelium-Descemet membrane complex for transplantation.

PURPOSE: Replacing diseased corneal endothelium with a preparation of Descemet membrane carrying functional endothelium and no stroma may be a feasible method for treating corneal endothelial decompensation. To obtain a viable donor of a Descemet membrane endothelium disc, we modified the Descemet membrane stripping technique and monitored the percentage of endothelial damage to the donor tissue preparation. METHODS: Forty-eight human corneas were used. Cornea buttons were mounted on an artificial anterior chamber, endothelial side up. Endothelia were stained with alizarin red, examined under the microscope, and photographed at 5 different sites (microscope, x100; digital magnification, x2.83). A 6 x 7-mm rectangular piece of endothelium-Descemet membrane complex was obtained using a Grieshaber microsurgical knife and Kelman-McPherson forceps. Digital photographs of endothelia were analyzed with a computer, and the percentage of endothelial damage was calculated. Specimens were processed for hematoxylin-eosin staining. RESULTS: Forty of 48 endothelium-Descemet membrane preparations (83.3%) were complete peels with minimal endothelial damage. Endothelial damage before and after the surgery was 1.57 +/- 2.11% and 2.61 +/- 1.77%, respectively. Eight preparations (16.7%) failed because of tearing. Multiple hematoxylin-eosin-stained sections showed the presence of endothelium with intact Descemet membrane and no stromal tissue. CONCLUSION: We modified the technique of Melles and obtained a sheet of Descemet membrane and endothelium with minimal endothelial damage and with no remaining stroma observed. This simple technique can be used to obtain the endothelium-Descemet membrane complex in minutes. It may be useful for corneal endothelium transplantation.

Adult↗
PubMedDate not supplied

Descemet membrane tear after cataract surgery.

Descemet membrane detachment is a potentially devastating complication of cataract surgery. Small localized detachments are rarely problematic, however persistent extensive detachments can affect visual acuity. In severe cases penetrating keratoplasty may be required for restoration of vision. One case of a persistent descemets membrane tear is presented and the progress after surgical repair via suture and injection of air is described. The patient was followed for 5 months after repair with persistent haze and mild corneal edema, though vision improved to 20/25+.

Aged↗
PubMed2004

Descemet membrane detachment caused by hydrogen peroxide injury.

OBJECTIVE: To describe a patient who developed a Descemet membrane detachment after hydrogen peroxide injury with successful reattachment by intracameral injection of sulfur hexafluoride gas. METHODS: Case report. RESULTS: The right eye of a 40-year-old man was exposed to 35% hydrogen peroxide. This resulted in a central corneal epithelial defect, corneal edema, a localized detachment of Descemet membrane, and a gas bubble between the posterior corneal stroma and Descemet membrane. The Descemet membrane detachment persisted after reabsorption of the gas bubble. Successful reattachment of Descemet membrane was achieved with injection of 0.15 mL of 20% sulfur hexafluoride gas into the anterior chamber. CONCLUSION: Hydrogen peroxide ocular injury may cause Descemet membrane detachment, and successful reattachment may be achieved with intracameral injection of 20% sulfur hexafluoride gas.

Adult↗
PubMed1999

Technique for repair of Descemet membrane detachment.

PURPOSE: To demonstrate a successful repair of an intractable Descemet membrane detachment. METHODS: Case report. We used transcorneal mattress sutures to fixate Descemet membrane to the cornea in combination with intracameral air injection. RESULT: This technique resulted in reattachment of Descemet membrane and a substantial visual acuity improvement after complete resolution of corneal edema. CONCLUSIONS: Surgical repair may be needed in cases of large Descemet membrane detachment. This technique provides an additional surgical alternative to repair intractable Descemet membrane detachment without causing excessive anterior chamber disruption; it may also prevent the need for a penetrating keratoplasty.

Aged↗
PubMed2006

Donor descemet membrane detachment after endothelial keratoplasty.

PURPOSE: To describe histopathologic characteristics of an endothelial keratoplasty (EK) that was performed to treat a previously failed penetrating keratoplasty (PK) and in which the cornea failed to clear after partial detachment of Descemet membrane from the EK donor button. The Descemet membrane and endothelium from the PK were intentionally retained during the EK procedure. METHODS: After EK, the cornea failed to fully clear in 5 months, and a PK was performed. The removed corneal button was grossly described and routinely processed for hematoxylin-eosin (H&E) and periodic acid-Schiff (PAS) staining, with photographs taken of any pertinent findings. RESULTS: Grossly on the endothelial side, there was some adherent iris pigment delineating an off-center fold in the EK Descemet membrane, consistent with intraoperative observation of a fold across the width of the donor button and postoperative slit-lamp images showing partial detachment of Descemet membrane. Microscopic examination revealed a recipient corneal button from a prior PK centrally and EK donor button attached posteriorly. Descemet membrane was not stripped from the prior PK during EK and was intact. No endothelial cells were detected on the PK Descemet membrane. The anterior stromal surface of the EK was well apposed to the prior PK Descemet membrane, with no pseudoanterior chamber or cleft of any type noted between them. The EK Descemet membrane had a central fold, and the endothelium was markedly attenuated. CONCLUSION: The EK graft was well apposed with apparent good adherence to the recipient's prior failed PK, and early endothelial failure was attributable to partial Descemet membrane detachment.

Adult↗
PubMed2000

Descemet membrane detachment after viscocanalostomy.

PURPOSE: To report a case that developed a large Descemet membrane detachment after viscocanalostomy. METHODS: Case report. A 60-year-old man with primary open-angle glaucoma underwent viscocanalostomy RE. One day after surgery, a small, localized detachment of Descemet membrane was present at the operation site. Six months after surgery, he had a large superior Descemet membrane detachment involving his visual axis. RESULTS: The Descemet membrane remained attached after descemetopexy with sodium hyaluronate and air. Final visual acuity was 20/80, and intraocular pressure was 17 mm Hg without medication. CONCLUSION: Detachment of the Descemet membrane should be recognized as a potential complication of viscocanalostomy.

Air↗
PubMed2004

Intracorneal hematoma with descemet membrane detachment after viscocanalostomy.

PURPOSE: To describe a case of intracorneal hematoma with Descemet membrane detachment after viscocanalostomy. DESIGN: Interventional case report. METHODS: A 63-year-old with uncontrolled primary open-angle glaucoma underwent viscocanalostomy. During the introduction of hyaluronate 2.3% under the superficial flap, a limited lysis of Descemet membrane was observed. RESULT: Slit-lamp biomicroscopy showed an intracorneal hematoma with Descemet membrane detachment 1 day after viscocanalostomy. The creation of an intentional break of Descemet membrane and descemetopexy using sulfur hexafluoride gas were performed. The cornea regained transparency after surgery. CONCLUSIONS: Intracorneal hematoma with Descemet membrane detachment is a possible complication of viscocanalostomy.

Anterior Chamber↗
PubMed2002

A new technique for repairing descemet membrane detachments using intracameral gas injection.

Descemet membrane detachments are not uncommon following cataract surgery, and large and extensive detachments can have an impressive presentation, with severe corneal edema and marked reduction in visual acuity. Traditional treatment regimens have included observation (with the hopes of spontaneous resolution), anterior chamber injections of air or viscoelastic, transcorneal suturing, and even corneal transplantation for persistent cases. During the past few years, intracameral injection with either sulfur hexafluoride (SF6) or perfluoropropane (C3F8) gas has gained increasing acceptance as an efficient and effective treatment option for Descemet membrane detachments. Previously described techniques of gas injection have required corneal and paracentesis incisions; sterile blades, cannulas, and other instruments; and occasionally, an operating room setting. We describe a simple, safe, and effective technique for intracameral gas injection that can be performed by one person at the slitlamp microscope or in a minor operating room with minimal equipment.

Cataract Extraction↗
PubMed2006

Descemet membrane endothelial keratoplasty (DMEK).

PURPOSE: To describe Descemet membrane endothelial keratoplasty (DMEK) with organ cultured Descemet membrane (DM) in a human cadaver eye model and a patient with Fuchs endothelial dystrophy. METHODS: In 10 human cadaver eyes and 1 patient eye, a 3.5-mm clear corneal tunnel incision was made. The anterior chamber was filled with air, and the DM was stripped off from the posterior stroma. From organ-cultured donor corneo-scleral rims, 9.0-mm-diameter "DM rolls" were harvested. Each donor DM roll was inserted into a recipient anterior chamber, positioned onto the posterior stroma, and kept in position by completely filling the anterior chamber with air for 30 minutes. RESULTS: In all recipient eyes, the donor DM maintained its position after a 30-minute air-fill of the anterior chamber followed by an air-liquid exchange. In the patient's eye, 1 week after transplantation, best-corrected visual acuity was 1.0 (20/20) with the patient's preoperative refraction, and the endothelial cell density averaged 2350 cells/mm. CONCLUSION: DMEK may provide quick visual rehabilitation in the treatment of corneal endothelial disorders by transplantation of an organ-cultured DM transplanted through a clear corneal tunnel incision. DMEK may be a highly accessible procedure to corneal surgeons, because donor DM sheets can be prepared from preserved corneo-scleral rims.

Corneal Transplantation↗
PubMed2004

Descemet membrane detachment with hemorrhage after alkali burn to the cornea.

PURPOSE: To report two cases of Descemet membrane detachment associated with hemorrhage after alkali burn to the cornea. DESIGN: Observational case reports. METHODS: We describe two patients with detachment of Descemet membrane associated with hemorrhage after alkali burns to the cornea. RESULTS: Patient 1 received a splash of caustic soda to the face. Descemet membrane detachment with hemorrhage was present. An attempt at reattachment using intraocular gases failed. Patient 2 sustained a chemical burn secondary to an airbag injury. A thickened, detached Descemet membrane associated with a hyphema was evident. CONCLUSIONS: Detachments of Descemet membrane associated with alkali burns are often accompanied by irreversible endothelial cell damage.

Burns, Chemical↗
PubMed2002

Descemet membrane detachment after sequential argon-neodymium:YAG laser peripheral iridotomy.

PURPOSE: To report a case of Descemet membrane detachment after sequential argon-neodymium (Nd):yttrium-aluminum-garnet (YAG) laser peripheral iridotomy. DESIGN: Interventional case report. METHODS: A 72-year-old Chinese man presented with acute primary angle-closure in the left eye. In the fellow right eye, a localized Descemet membrane detachment developed after prophylactic sequential argon-Nd:YAG laser peripheral iridotomy. Ultrasound biomicroscopy pictures were taken. RESULTS: The Descemet membrane detachment reattached gradually without intervention. The cornea remained clear and the vision was unchanged. CONCLUSION: In sequential argon-Nd:YAG laser peripheral iridotomy, the shock wave formed during photodisruption may produce linear cracks at the level of Descemet membrane, resulting in detachment. This complication can occur irrespective of the color of the iris.

Aged↗
PubMed2002

Descemet membrane detachment after nonpenetrating filtering surgery.

PURPOSE: To make surgeons performing nonpenetrating filtering surgery aware of an unusual complication namely Descemet membrane detachment. METHODS: We retrospectively reviewed nine eyes of nine patients seen in our hospital with Descemet membrane detachment occurring after nonpenetrating filtering surgery from January 1994 to December 2000. RESULTS: Both planar and nonplanar detachments were reported. Neither scrolls nor tears in the Descemet membrane were observed in any patient. After viscocanalostomy (four patients), the detachment was generally noticed shortly after the procedure and the cornea maintained its clarity. After deep sclerectomy with a collagen implant (five patients), it developed weeks to months postoperatively with adjacent corneal edema. Four patients had descemetopexy. None required more than one procedure. However, at the last visit, two detachments persisted although they had diminished in size: one after viscocanalostomy and conservative treatment and one after descemetopexy after deep sclerectomy with a collagen implant. To date otherwise, no signs of significant corneal damage could be observed clinically nor by specular microscopy and pachymetry. CONCLUSIONS: The diagnosis of Descemet membrane detachment can be easily overlooked or misdiagnosed. The clinical presentation, clinical course, and pathogenesis depend on the type of nonpenetrating filtering surgery performed. Ophthalmologists should be aware of this unusual complication, which is likely to be more common after nonpenetrating filtering surgery than after trabeculectomy. A period of observation before attempting descemetopexy is recommended.

Adult↗
PubMed2006

Spontaneous resolution of descemet membrane detachment after deep anterior lamellar keratoplasty.

PURPOSE: To describe a patient whose Descemet membrane detachment following deep lamellar keratoplasty failed to respond to 2 attempts at gas tamponade but later resolved spontaneously. METHODS: A 77-year-old woman with bilateral anterior corneal stromal scarring underwent a right deep lamellar keratoplasty with the Melles technique. Postoperatively, she developed an inferior Descemet membrane detachment, presumably due to a peripheral inferior microperforation. Two attempts at gas tamponade with sulfur hexafluoride (SF6) and 12% perfluropropane (C3F8) were made. RESULTS: Gas tamponade was unsuccessful. Five months after deep lamellar keratoplasty, the detachment resolved spontaneously. One year after deep lamellar keratoplasty, the donor cornea was clear, and best corrected visual acuity in the right eye was 20/40 with -2.75/+2.50 x 55. CONCLUSIONS: Descemet membrane detachment after deep anterior lamellar keratoplasty can resolve spontaneously, even after failed attempts at gas tamponade. Those due to peripheral inferior perforations may be less likely to respond to tamponade than central or superior perforations.

Aged↗
PubMed1996

Extensive detachment of Descemet membrane after holmium laser sclerostomy.

PURPOSE: To describe a corneal complication and its surgical repair after holmium laser sclerostomy. METHOD: A 63-year-old woman had extensive detachment of Descemet membrane 3 months after holmium laser sclerostomy. The authors describe the case history of a detached Descemet membrane secondary to holmium laser sclerostomy and its subsequent repair. RESULTS: The patient achieved a visual acuity of 20/20 in the involved eye after descemetopexy with sodium hyaluronate and air combined with suturing. CONCLUSIONS: Detachment of the Descemet membrane should be recognized as a potential complication of holmium laser sclerostomy. Suturing should be considered as a method of repair if there is not spontaneous reattachment of the Descemet membrane.

Corneal Diseases↗
PubMed2002

[Spontaneous clearing of the cornea with detachment of Descemets membrane].

UNLABELLED: Detachment of Descemet's membrane (DM) is a rare complication of cataract and glaucoma surgery. Although permanent corneal edema is the usual outcome of a large detachment, spontaneous clearing of the cornea may occur. CASE REPORT: A 55-year-old man underwent trabeculectomy in 1991 under local anesthesia. One day later the cornea was edematous, with a large superior DM detachment curling inward in the anterior chamber, limited by a thin blood pigmented line. Two months after cornea had cleared, and remained clear for ten years, with 20/20 visual acuity and intraocular pressure of 14mmHg. DISCUSSION: Small detachments of DM after surgery are not rare and usually reattach spontaneously. However, extensive detachment results in overlying corneal edema and may require surgical reapposition. In our case, the cornea cleared spontaneously in the absence of DM repositionning, as denuded corneal stroma may be covered by newly regenerated DM. Before any surgical repair of DM detachment, one should consider spontaneous clearing of the cornea as a possible outcome.

Corneal Diseases↗
PubMed1996

Changes in descemet membrane and endothelium after corneal epithelial abrasion alone and with photorefractive keratectomy in rabbits.

OBJECTIVES: To investigate the effects of epithelial abrasion on the corneal endothelium and Descemet membrane in rabbits and to compare the changes with those after excimer laser photoablation of the cornea. METHODS: Central epithelial abrasions, 6 mm in diameter, were created by mechanical removal of the cells, and the specimens were examined from 24 hours up to 30 days by transmission electron microscopy. Corneas that were photoablated by an excimer laser and nontreated normal corneas were investigated as controls. RESULTS: Corneas denuded of epithelium showed massive enlargement of the mitochondria in the endothelium and exhibited a layer of electron-dense fibrillogranular material that had migrated forward through the Descemet membrane. These alterations were similar to the changes observed after photoablation of the cornea by an excimer laser. CONCLUSION: It was postulated that the extrusion of electron-dense material in the Descemet membrane observed after excimer laser ablation might have occurred primarily not as a result of shock waves, but from destruction of the epithelial integrity.

Animals↗
PubMed2004

A technique to excise the descemet membrane from a recipient cornea (descemetorhexis).

OBJECTIVE: To describe a technique for excision of the Descemet membrane (DM) from the recipient eye for preparation of a recipient stromal bed in posterior lamellar keratoplasty. METHODS: In 10 human eye bank eyes and 3 patients, recipient eyes had a 5.0-mm scleral tunnel incision made extending 1.0 mm into the peripheral cornea at the 12 o'clock surgical position. The anterior chamber was completely filled with air, and a reflective glide was placed through the incision onto the iris, to better visualize DM. A 9.0-mm mark was made onto the corneal epithelium to outline the area from which the Descemet membrane was to be removed. With a custom-made scraper, the DM was then carefully stripped off the posterior stroma by loosening the membrane at the 6 o'clock position and pulling it toward the incision at 12 o'clock. The excised DMs were evaluated by light and electron microscopy. RESULTS: In all recipient eyes, DM could be easily and completely removed from the posterior corneal stroma. Microscopy showed isolated DMs without stromal tissue elements. CONCLUSION: With the technique described, DM can be excised in a controlled fashion without damaging the posterior corneal stroma, to quickly create a recipient stromal bed before implantation of a donor posterior lamellar disk in posterior lamellar keratoplasty.

Corneal Stroma↗