Tractional Descemet’s membrane detachment after ocular alkali burns: case reports and review of literature

BACKGROUND: Descemet’s membrane detachment (DMD) is a rare complication after ocular chemical injury and its pathogenesis remains unclear. In this study, we reported two cases of DMD with traction demonstrated on Anterior segment optical coherence tomography (AS-OCT). CASE PRESENTATION: Two patients sustained ocular chemical injury with 50% sodium hydroxide. In both cases, AS-OCT revealed detached Descemet’s membrane that was adherent to the underlying iris tissue in the inferior quadrant at 45 days and 34 days after the injury respectively. The first case received intracameral tamponade with 12% C(3)F(8) gas and the second case received corticosteroid and sodium chloride 5% eye drops. However, DMD persisted in both cases. CONCLUSIONS: The atypical features of DMD on anterior segment optical coherence tomography in our cases suggested the presence of an inflammatory component caused adhesions and traction of iris to Descemet’s membrane and prevented reattachment of DMD even with gas tamponade.