A prospective analysis on the outcomes of descemetopexy procedures for Descemet's membrane detachment post-cataract surgery

• Main Authors: Anuraag Gandhi, Sabyasachi Chakrabarty, Anitha Venugopal, Shivkumar Chandrashekharan, Aditya Ghorpade
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: TNOA Journal of Ophthalmic Science and Research
• Subjects: air descemetopexy; descemet's membrane detachment; descemetopexy; nonplanar descemet's membrane detachment; planar descemet's membrane detachment
• Online Access: http://www.tnoajosr.com/article.asp?issn=2589-4528;year=2020;volume=58;issue=3;spage=148;epage=153;aulast=Gandhi

Aims: The aim of this study is to analyze the outcomes of air descemetopexy with/without suture augmentation (AD) for Descemet's membrane detachment (DMD) post-cataract surgery. Materials and Methods: This prospective study included 51 eyes that underwent AD at a tertiary hospital. The outcome measures were successful Descemet's membrane (DM) reattachment and improvement in visual acuity by at least two Snellen lines. Statistical Analysis: Mean, standard deviation, and percentage were used to summarize the data. Wilcoxon signed-rank test, Chi-square test, and Fischer's exact test were used to calculate statistical significance. P < 0.05 was considered statistically significant. Results: Out of 52,396 cataract surgeries, 51 patients required surgical intervention for DMD, postoperatively. The mean age of the participants was 66.67 ± 9.8 years with a male: female ratio of 6:11. A nonplanar DMD was found in 56.87% (n = 29). The most common surgery preceding DMD was small incision cataract surgery (68.6%; n = 35). The mean interval between cataract surgery and descemetopexy was 9.3 ± 7.9 days. The mean pre- and post-descemetopexy visual acuities were 1.01 ± 0.6 and 0.44 ± 0.49, respectively (P < 0.00001). After an air tamponade, an additional suture (s) had to be placed in 62.8% (n = 32) cases, out of which 23 required a single suture, seven needed two sutures, and two needed three sutures. A successful DM reattachment was seen in 92.2% (n = 47) with the first attempt. There was a statistically significant improvement in visual acuity post-descemetopexy irrespective of the timing of surgery (P < 0.001 for all surgeries performed within 2 weeks and P = 0.03 for surgeries performed later). Conclusion: AD is a safe and effective procedure for the treatment of post-cataract surgery DMD.