Usefulness of anterior segment optical coherence tomography in descemet’s membrane detachment following cataract surgery

Vasu Kamaladevi Lathika, Uvaraj Thresika, Sebastian Nayana


Background: Postoperative descemet’s membrane detachments (DMD) can be vision threatening if not detected early and managed appropriately Eyes with DMD usually have corneal haze which may hamper slitlamp evaluation. Anterior segment optical coherence tomography (ASOCT) is a precise, non-invasive imaging technique that yields high resolution cross sectional images of the cornea. This study aims to evaluate the usefulness of AS OCT as compared to slitlamp biomicroscopy in the detection and management of post-operative DMD following small incision cataract surgery.

Methods: It was a prospective study on sixty-seven patients who underwent cataract surgery. Slitlamp biomicroscopy and ASOCT were done in all patients on postoperative day one. The presence of descemet’s membrane detachment was noted using each technique. Eyes with DMD were followed up one week and again one month later. ASOCT was repeated to assess the status of DMD. Management was planned accordingly

Results: On post-operative day one, only 1.49% of the study group showed descemet’s detachment on slitlamp biomicroscopy, as against 20.89% using ASOCT. This increase in diagnostic yield on ASOCT was statistically significant(p=0.05). On follow-up, descemet’s membrane had reattached in seven eyes one week after surgery and in all eyes one month after surgery, with medical management alone.

Conclusions: AS OCT has a definite advantage over slit lamp biomicroscopy in the detection of descemet’s membrane detachment following cataract surgery. Our study also validates the fact that AS OCT helps in follow up and decision making in the management of DMD.


Anterior segment OCT, Biomicroscopy, Cataract surgery, Descemet’s membrane detachment, Slit lamp

Full Text:



Jaffe NS, Jaffe MS, Jaffe GF. Cataract surgery and its complications. St. Louis: Mosby. 1997.

Elkady B, Piñero D, Alió JL. Corneal incision quality: microincision cataract surgery versus microcoaxial phacoemulsification. J Cataract & Refractive Surgery. 2009;35(3):466-74.

Xia Y, Liu X, Luo L, Zeng Y, Cai X, Zeng M, et al. Early changes in clear cornea incision after phacoemulsification: an anterior segment optical coherence tomography study. Acta Ophthalmol (Copenh). 2009;87(7):764-8.

Agarwal A, Jacob S. Descemet’s membrane detachment: A new classification system:New classification system for Descemet’s membrane detachment requires new treatment methods. Ocular Surgery News U.S. Edn. 2013.

Lyles CW, Kin C, Larri D. 'OCT-documented incision features and natural history of clear corneal incisions used for bimanual microincision cataract surgery. Cornea. 2011;30(6):E81-b.

Cavanagh HD, El-Agha MS, Petra WM, Jester N. Specular microscopy, confncal microscopy, and ultrasound biornicroscopy: diagnostic tools of the past quarter century. Cornea. 2000;19(5):712-22.

Kaluzny BJ, Kaluzny JJ, Szkulmowska A, Gorczynska I, Szkulmowski M, Bajraszewski T, et al. Spectral optical coherence tomography: a novel technique for cornea imaging. Cornea. 2006;25(8):960-5.

Bechmann M, Thiel MJ, Neubauer AS, Ullrich S, Ludwig K, Kenyon KR, et al. Central corneal thickness measurement with a retinal optical coherence tomography device versus standard ultrasonic pachymetry. Cornea. 2001;20(1):50-4.

Kothari S, Kothari K, Parikh RS. Role of anterior segment optical coherence tomogram in Descemet’s membrane detachment. Indian J Ophthalmol. 2011;59(4):303-5.

Mackool R, Holtz S. Descemet Membrane Detachment. Archives of Ophthalmol. 1977;95(3):459-63.

Kumar D. Managing Descemet Membrane Detachment by HELP Algorithm. Delhi J Ophthalmol. 2016;27(2):128-31.