Spontaneous Resolution of Descemet Membrane Detachment After Deep Anterior Lamellar Keratoplasty

Abstract

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.

Comparison of Techniques Used for Removing the Recipient Stroma in Anterior Lamellar Keratoplasty

“…A double anterior chamber occurred after ALK in 9% of patients (6/69), but in only 1 patient did this complication lead to graft failure. In the other 5 patients, it resolved either spontaneously or after graft resuturing combined with air injection in the anterior chamber, as previously reported by Tu et al 35 One main advantage of ALK compared with PK is the absence of endothelial rejection. However, stromal rejection and epithelial rejection are still possible after lamellar keratoplasty.…”

Deep anterior lamellar keratoplasty

“…Although Reproduced with permission [22]. spontaneous resolution can happen in long-standing cases [24], surgical intervention recommended due to potential damage to the endothelium.…”

Spontaneous resolution of double anterior chamber with perforation of Descemet′s membrane in deep anterior lamellar keratoplasty

“…Indications for DALK include corneal scars from healed infectious keratitis or superficial trauma, anterior corneal dystrophies, stromal corneal dystrophies, and ectatic disorders such as keratoconus and pellucid marginal degeneration. [3] A popular technique for cleaving the stroma at a predetermined depth for DALK is the Big Bubble technique of Anwar. [1] Here injection of air bubble into the deep stroma cleaves the posterior stroma leaving behind a clear DM.…”

“…Postoperatively, the corneal endothelium may maintain its viability and resume function after prolonged detachment from the stromal bed. [3] Return of normal pumping produces a pressure gradient between the 2 chambers, pumping fluid from the interface of secondary chamber to the main anterior chamber. This in turn promotes reattachment.…”