A new clinico-tomographic classification and management algorithm for Descemet's membrane detachment.

Objective: To propose a new clinico-tomographic classification of Descemet's detachment (DD).Methods: Interventional case series of 35 eyes with DD were clinico-tomographically classified as: (1)Rhegmatogenous DD (RDD)-lax, free floating DM secondary to DM tear/hole/dialysis; ASOCT showing undulatin...

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Publicado en:Contact Lens & Anterior Eye Vol. 38; no. 5; pp. 327 - 334
Autores principales: Jacob, Soosan, Agarwal, Amar, Chaudhry, Prashaant, Narasimhan, Smita, Chaudhry, Vidya Nair
Formato: clinical trial research Journal Article
Publicado: Elsevier B.V. Oct2015
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2015
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      pub: Elsevier B.V.
      place: New York, New York
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        109647466
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        10.1016/j.clae.2015.03.012
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        109647466
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        atl: A new clinico-tomographic classification and management algorithm for Descemet's membrane detachment.
      aug:
        au:
          Jacob, Soosan
          Agarwal, Amar
          Chaudhry, Prashaant
          Narasimhan, Smita
          Chaudhry, Vidya Nair
      sug:
      ab: Objective: To propose a new clinico-tomographic classification of Descemet's detachment (DD).Methods: Interventional case series of 35 eyes with DD were clinico-tomographically classified as: (1)Rhegmatogenous DD (RDD)-lax, free floating DM secondary to DM tear/hole/dialysis; ASOCT showing undulating linear signal with total length equalling overlying stromal arc length. (2) Tractional DD (TDD)-foreshortened, taut DM with tractional/fibrotic component; ASOCT showing detached DM chord length less than overlying stromal arc length. (3) Bullous DD (BDD)-bulge of DM into AC in absence of DM break or needle puncture break too small to allow egress of contents; ASOCT showing convex signal. (4) Complex DD (CDD)-Complex variants and combinations seen clinically and on ASOCT.Results: RDD was most common (n=23), 19 were RDD with tear (post-surgical) treated by observation(n=3)/pneumodescemetopexy(n=16), 2 were RDD with hole due to inadvertent DM perforation in deep anterior lamellar keratoplasty treated by pneumodescemetopexy and fibrin glue, 2 were RDD with dialysis post-Descemetorhexis in Descemet's Membrane Endothelial Keratoplasty, not requiring treatment. TDD (n=4) was treated by relaxing Descemetotomy (n=3) or EK (n=1, poor endothelium); BDD (n=3) with two improving spontaneously; CDD (n=5) treated by refloatation with air (n=3)/EK (n=1)/penetrating keratoplasty (n=1).Conclusion: Treatment and prognosis of DD varies based on etio-morphology. This classification allows systematic approach for diagnosis, management and prognostication.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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