Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery
Identifieur interne : 000220 ( Main/Exploration ); précédent : 000219; suivant : 000221Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery
Auteurs : Melina I. Morkin [États-Unis] ; Rehan M. Hussain [États-Unis] ; Ryan C. Young [États-Unis] ; Tracy Ravin [États-Unis] ; Sander R. Dubovy [États-Unis] ; Eduardo C. Alfonso [États-Unis]Source :
- Clinical Ophthalmology (Auckland, N.Z.) [ 1177-5467 ] ; 2014.
Abstract
A 51-year-old male who had undergone phacoemulsification in his left eye 11 months prior presented with complaint of sudden onset of blurred vision in the same eye. Review of his clinical course, slit-lamp exam, pachymetry, and specular endothelial microscopy led to the diagnosis of acute hydrops caused by Descemet’s membrane dehiscence at the site of the incision. He was initially managed with medical treatment and observation. In the subsequent months of follow-up, the corneal edema and the patient’s visual acuity did not improve. Intracameral gas injection was performed 7 months after presentation, but because of persistent corneal edema and nonattached Descemet’s membrane, penetrating keratoplasty was performed. Histopathologic examination confirmed the diagnosis. The patient has had a clear corneal graft since then. Although Descemet’s membrane detachment is a rather common complication after intraocular surgery, its unusually delayed presentation can also occur, and should not be confused with pseudophakic bullous keratopathy. Many mechanisms have been studied for the development of early tears and detachments after cataract surgery, but little is known about late presentations. The authors explore possible causes, and highlight the importance of instructing patients to avoid eye rubbing and any other type of trauma to the cornea after intraocular surgery.
Url:
DOI: 10.2147/OPTH.S65520
PubMed: 25210431
PubMed Central: 4155894
Affiliations:
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Morkin</name><affiliation wicri:level="2"><nlm:aff id="af1-opth-8-1629">Department of Ophthalmology, Shiley Eye Center, University of California – San Diego, San Diego, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Shiley Eye Center, University of California – San Diego, San Diego, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="af2-opth-8-1629">Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Hussain, Rehan M" sort="Hussain, Rehan M" uniqKey="Hussain R" first="Rehan M" last="Hussain">Rehan M. Hussain</name><affiliation wicri:level="2"><nlm:aff id="af2-opth-8-1629">Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Young, Ryan C" sort="Young, Ryan C" uniqKey="Young R" first="Ryan C" last="Young">Ryan C. Young</name><affiliation wicri:level="2"><nlm:aff id="af2-opth-8-1629">Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Ravin, Tracy" sort="Ravin, Tracy" uniqKey="Ravin T" first="Tracy" last="Ravin">Tracy Ravin</name><affiliation wicri:level="2"><nlm:aff id="af2-opth-8-1629">Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Dubovy, Sander R" sort="Dubovy, Sander R" uniqKey="Dubovy S" first="Sander R" last="Dubovy">Sander R. Dubovy</name><affiliation wicri:level="2"><nlm:aff id="af2-opth-8-1629">Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Alfonso, Eduardo C" sort="Alfonso, Eduardo C" uniqKey="Alfonso E" first="Eduardo C" last="Alfonso">Eduardo C. Alfonso</name><affiliation wicri:level="2"><nlm:aff id="af2-opth-8-1629">Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author></analytic><series><title level="j">Clinical Ophthalmology (Auckland, N.Z.)</title><idno type="ISSN">1177-5467</idno><idno type="eISSN">1177-5483</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>A 51-year-old male who had undergone phacoemulsification in his left eye 11 months prior presented with complaint of sudden onset of blurred vision in the same eye. Review of his clinical course, slit-lamp exam, pachymetry, and specular endothelial microscopy led to the diagnosis of acute hydrops caused by Descemet’s membrane dehiscence at the site of the incision. He was initially managed with medical treatment and observation. In the subsequent months of follow-up, the corneal edema and the patient’s visual acuity did not improve. Intracameral gas injection was performed 7 months after presentation, but because of persistent corneal edema and nonattached Descemet’s membrane, penetrating keratoplasty was performed. Histopathologic examination confirmed the diagnosis. The patient has had a clear corneal graft since then. Although Descemet’s membrane detachment is a rather common complication after intraocular surgery, its unusually delayed presentation can also occur, and should not be confused with pseudophakic bullous keratopathy. Many mechanisms have been studied for the development of early tears and detachments after cataract surgery, but little is known about late presentations. The authors explore possible causes, and highlight the importance of instructing patients to avoid eye rubbing and any other type of trauma to the cornea after intraocular surgery.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wong, Vk" uniqKey="Wong V">VK Wong</name></author><author><name sortKey="Koenig, Sb" uniqKey="Koenig S">SB Koenig</name></author><author><name sortKey="Fogel, Es" uniqKey="Fogel E">ES Fogel</name></author><author><name sortKey="Freedman, Mi" uniqKey="Freedman M">MI Freedman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stewart, Cm" uniqKey="Stewart C">CM Stewart</name></author><author><name sortKey="Li, F" uniqKey="Li F">F Li</name></author><author><name sortKey="Mcalister, Jc" uniqKey="Mcalister J">JC McAlister</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chow, Vw" uniqKey="Chow V">VW Chow</name></author><author><name sortKey="Agarwal, T" uniqKey="Agarwal T">T Agarwal</name></author><author><name sortKey="Vajpayee, Rb" uniqKey="Vajpayee R">RB Vajpayee</name></author><author><name sortKey="Jhanji, V" uniqKey="Jhanji V">V Jhanji</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bhattacharjee, H" uniqKey="Bhattacharjee H">H Bhattacharjee</name></author><author><name sortKey="Bhattacharjee, K" uniqKey="Bhattacharjee K">K Bhattacharjee</name></author><author><name sortKey="Medhi, J" uniqKey="Medhi J">J Medhi</name></author><author><name sortKey="Altaf, A" uniqKey="Altaf A">A Altaf</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Mezaine, Hs" uniqKey="Al Mezaine H">HS Al-Mezaine</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kansal, S" uniqKey="Kansal S">S Kansal</name></author><author><name sortKey="Sugar, J" uniqKey="Sugar J">J Sugar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hirano, K" uniqKey="Hirano K">K Hirano</name></author><author><name sortKey="Kojima, T" uniqKey="Kojima T">T Kojima</name></author><author><name sortKey="Nakamura, M" uniqKey="Nakamura M">M Nakamura</name></author><author><name sortKey="Hotta, Y" uniqKey="Hotta Y">Y Hotta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Streeten, Bw" uniqKey="Streeten B">BW Streeten</name></author><author><name sortKey="Qi, Y" uniqKey="Qi Y">Y Qi</name></author><author><name sortKey="Klintworth, Gk" uniqKey="Klintworth G">GK Klintworth</name></author><author><name sortKey="Eagle, Rc" uniqKey="Eagle R">RC Eagle</name></author><author><name sortKey="Strauss, Ja" uniqKey="Strauss J">JA Strauss</name></author><author><name sortKey="Bennett, K" uniqKey="Bennett K">K Bennett</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shalchi, Z" uniqKey="Shalchi Z">Z Shalchi</name></author><author><name sortKey="O Rart, Dp" uniqKey="O Rart D">DP O’Brart</name></author><author><name sortKey="Ilari, L" uniqKey="Ilari L">L Ilari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Felipe, Af" uniqKey="Felipe A">AF Felipe</name></author><author><name sortKey="Rapuano, Cj" uniqKey="Rapuano C">CJ Rapuano</name></author><author><name sortKey="Nottage, Jm" uniqKey="Nottage J">JM Nottage</name></author><author><name sortKey="Abazari, A" uniqKey="Abazari A">A Abazari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ti, Se" uniqKey="Ti S">SE Ti</name></author><author><name sortKey="Chee, Sp" uniqKey="Chee S">SP Chee</name></author><author><name sortKey="Tan, Dt" uniqKey="Tan D">DT Tan</name></author><author><name sortKey="Yang, Yn" uniqKey="Yang Y">YN Yang</name></author><author><name sortKey="Shuang, Sl" uniqKey="Shuang S">SL Shuang</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li><li>Floride</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Morkin, Melina I" sort="Morkin, Melina I" uniqKey="Morkin M" first="Melina I" last="Morkin">Melina I. Morkin</name></region><name sortKey="Alfonso, Eduardo C" sort="Alfonso, Eduardo C" uniqKey="Alfonso E" first="Eduardo C" last="Alfonso">Eduardo C. Alfonso</name><name sortKey="Dubovy, Sander R" sort="Dubovy, Sander R" uniqKey="Dubovy S" first="Sander R" last="Dubovy">Sander R. Dubovy</name><name sortKey="Hussain, Rehan M" sort="Hussain, Rehan M" uniqKey="Hussain R" first="Rehan M" last="Hussain">Rehan M. Hussain</name><name sortKey="Morkin, Melina I" sort="Morkin, Melina I" uniqKey="Morkin M" first="Melina I" last="Morkin">Melina I. Morkin</name><name sortKey="Ravin, Tracy" sort="Ravin, Tracy" uniqKey="Ravin T" first="Tracy" last="Ravin">Tracy Ravin</name><name sortKey="Young, Ryan C" sort="Young, Ryan C" uniqKey="Young R" first="Ryan C" last="Young">Ryan C. Young</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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