Unintentional Descemet Cleft Introduces Novel Mechanism of Maintenance of Corneal Clarity. Issue 1 (28th January 2023)

• Record Type: Journal Article
• Authors: Sherif, Noha A.; Fleischman, David; Knight, O'Rese J.
• Is Part Of: Cornea. Volume 42:Issue 1(2023)
• Page Start: 113
• Page End: 115
• Publication Date: 2023-01-28
• Subjects: Descemet cleft -- Descemet membrane detachment -- corneal transparency -- corneal endothelial cells -- corneal endothelium; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000003099
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Supplemental Digital Content is Available in the Text. Abstract : Purpose: The purpose of this study was to report a case of corneal transparency for 7 months after the formation and persistence of a Descemet fluid cleft. Methods: We report the case of a 64-year-old woman undergoing anterior chamber reformation 2 months after Baerveldt implantation of the right eye. During the procedure, the ophthalmic viscoelastic was inadvertently injected into the posterior stroma, nearly isolating the corneal endothelial cell layer, and creating a Descemet fluid cleft filled with viscoelastic. The patient was managed conservatively and monitored near monthly for corneal decompensation. Results: The cornea remained centrally clear for 207 days after the initial anterior chamber reformation until the collapse of the viscoelastic cleft. When the cleft completely collapsed, the cornea became diffusely edematous, and the patient underwent cataract removal and intraocular lens placement without need for Descemet stripping endothelial keratoplasty to maintain vision. During these 7 months, the patient's best-corrected visual acuity remained stable at 20/25 +2 or better. Intraocular pressure was also stable, averaging 18.2 mm Hg. Conclusions: We hypothesize that corneal transparency can be maintained in the absence of endothelial cell function provided that aqueous humor cannot reach the cornea and disrupt the arrangement of the interfibrillar space.