DETACHMENT OF DESCEMETS-MEMBRANE

Purpose: To determine predisposing factors; best method of treatment, and the final outcome in cases of Descemet's membrane detachment. Sett ing: A tertiary care teaching eye hospital. Methods: All cases of Desc emet's detachment from: January 1986 to May 1994 were retrospectively reviewed. Twelve eyes of 11 patients with partial or total detachment of Descemet's membrane were identified. Patients with small localized detachments at the incision: area were excluded. Results: All but one patient had surgical repair. Ten eyes had successful reattachment afte r up to four attempts at repair. Methods of:repair included intracamer al air or sulfur hexafluoride (SF6) 20% gas, with or without corneal s utures. After a follow up of 3 to 79 months, eight eyes retained clear corneas, four eyes developed corneal edema and scarring, and two requ ired penetrating keratoplasty. No definite predisposing factor could b e identified, although four eyes had preoperative diagnoses of glaucom a and recent corneal edema. Conclusion: Surgical repair with injection of intracameral air or SF6 20% was successful in most cases of Descem et's membrane detachment. A preoperative diagnosis of glaucoma and a r ecent episode of corneal edema may increase the risk of detachment.