Managing Descemet Membrane Detachment by HELP Algorithm

Descemet’s membrane detachment (DMD) is a known intraoperative complication following a complicated cataract surgery. We present an anterior segment coherence tomography based algorithm using Height, length, extent and pupil (HELP) for management of post operative DMD. If the DMD length is less than...

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Bibliographic Details
Main Authors: Dhivya Ashok Kumar, Amar Agarwal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-10-01
Series:Delhi Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.7869/djo.225
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Summary:Descemet’s membrane detachment (DMD) is a known intraoperative complication following a complicated cataract surgery. We present an anterior segment coherence tomography based algorithm using Height, length, extent and pupil (HELP) for management of post operative DMD. If the DMD length is less than 1mm and height < 100 microns in any zone (Zone 1 =central 5mm, Zone 2 =5-8mm & Zone 3 = >8mm), medical management is sufficient. When the detachment is 1-2mm with height of 100-300 microns in zone 1(with or without pupillary axis involvement), a surgical repositioning has to be considered. DMD with length 1-2mm and height 100-300 μm in zone 2 and 3 are managed medically. DMD >2mm long and height >300 μm in zone 1 & 2 are surgically treated; while the same in zone 3 are managed medically. With non improvement by 4 weeks under medical management, surgical intervention can be opted. Through early surgical intervention, even in cases with small Descemet membrane detachments and timely switch of treatment, the visual loss caused by Descemet membrane scarring can be prevented.
ISSN:0972-0200
2454-2784