Detachment of Descemet's membrane

Abstract Purpose: To determine predisposing factors, best method of treatment, and the final outcome in cases of Descemet's membrane detachment. Setting: A tertiary care teaching eye hospital. Methods: All cases of Descemet'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 after up to four attempts at repair. Methods of repair included intracameral air or sulfur hexafluoride (SF 6 ) 20% gas, with or without corneal sutures. After a followup of 3 to 79 months, eight eyes retained clear corneas, four eyes developed corneal edema and scarring, and two required penetrating keratoplasty. No definite predisposing factor could be identified, although four eyes had preoperative diagnoses of glaucoma and recent corneal edema. Conclusion: Surgical repair with injection of intracameral air or SF 6 20% was successful in most cases of Descemet's membrane detachment. A preoperative diagnosis of glaucoma and a recent episode of corneal edema may increase the risk of detachment.