You are here

Article Text

Article menu
Download PDFPDF
Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Manual schism and intracameral air injection for impacted Descemet’s membrane detachment
  1. Ashok Sharma1,2,
  2. Rajan Sharma2,
  3. Ashish Kulshreshta3 and
  4. Verinder Nirankari4
  1. 1Ophthalmology, Dr Ashok Sharma's Cornea Centre, Chandigarh, UT, India
  2. 2Cornea Service, Dr Ashok Sharma's Cornea Centre, Chandigarh, UT, India
  3. 3Cornea Service, New Chandigarh Eye Hospital, New Chandigarh, Punjab, India
  4. 4Department of Ophthalmology, University of Maryland School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Ashok Sharma; asharmapgius{at}yahoo.com

Abstract

A woman in her 60s was referred to us for management of poor vision following cataract surgery in the right eye. She had undergone manual small incision cataract surgery 12 weeks earlier. Slit-lamp biomicroscopy revealed corneal oedema, a horizontal line at the upper border and the adhered inferior border of detached Descemet’s membrane (DM). Clinical diagnosis of impacted Descemet’s membrane detachment (DMD) was considered.

Surgical intervention with manual schisis and intracameral injection of air was planned. Using the ‘push technique,’ we tried to place the tip of the 27 gauge cannula between the back of the cornea and detached DM. The tip of the 27 gauge cannula was behind the impacted DM, and air injection was unsuccessful. Using the back-up the ‘pull technique,’ bent tip of the 27 gauge cannula was used to pull the impacted DMD. This manoeuvre, disimpacted the inferior border and the air bubble, was injected using the 27 gauge cannula. The air bubble unfolded and reattached the DM successfully.

  • Eye
  • Ophthalmology
  • Anterior chamber
  • Air leaks
  • Healthcare improvement and patient safety

https://doi.org/10.1136/bcr-2022-253252

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: AS, RS, AK and VN; The following authors gave final approval of the manuscript: AS and VN.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.