Complex Descemet's Membrane Tears and Detachment during Phacoemulsification

PURPOSE: To report a case of complex Descemet's membrane detachment (DMD) and tears during phacoemulsification cataract surgery. CASE REPORT: A 64-year-old woman underwent phacoemulsification surgery in her right eye and developed tears and partial loss of Descemet's membrane (DM) while the aspiration port was inserted through the main incision. Massive corneal edema obscured the view and the anterior chamber was barely visible the following day. Scheimpflug imaging was used to complement slit lamp examination in the postoperative period. Frequent topical corticosteroid drops were initiated. After 5 days of treatment, multiple tears and detachment of DM were visible and the anterior chamber was filled with air. After 5 weeks, the cornea regained much of its clarity despite large DM tears and focal loss of DM. CONCLUSION: Despite partial loss of DM, the corneal edema mostly disappeared after 5 weeks of air bubble injection. Scheimpflug imaging was beneficial in the diagnosis and monitoring of DM tears and detachments.