Wylegala Edward, Nowinska Anna Anterior Segment Optical Coherence Tomography in Descemet’s Membrane Detachment After Cataract Surgery Wylegala Edward, Nowinska Anna Nursing Dept. and Social Medical Issues, Health Care Division, Silesian Medical University, Katowice, Poland; Head: Edward Wylegala, MD, PhD Dept. of Ophthalmology, District Railway Hospital, Katowice, Poland; Head: Edward Wylegala, MD, PhD

PURPOSE To evaluate the usefulness of the anterior chamber optical coherence tomography (VisanteTM OCT ) in diagnosis and monitoring the results of treatment of Descemet’s membrane detachment after cataract surgery

Material and methods OCT 8 eyes of 8 patients with Descemet’s membrane detachment from 2005 to 2007 phacoemulsification cataract surgery (3,0 or 3,2 mm incision) Additional slit lamp findings number of eyes Fuchs endothelial dystrophy 1 pseudoexfoliation syndrome angle-closure glaucoma 2 confirm or make the diagnosis evaluate the configuration of detachment monitor treatment results OCT

Results Diagnosis of Descemet’s membrane detachment CONFIGURATION BASED ON OCT eye days to diagnosis visual acuity CCT (μm) planar nonplanar with scrolling without scrolling 1 20/2000 876 γ 2 20/1000 823 3 20/60 598 4 20/100 647 5 923 6 911 7 20/80 615 8 850 CCT = central corneal thickness

Results Configuration of detachment based on OCT examination localized planar exstensive nonplanar exstensive nonplanar with scrolling

Results Treatment method and outcome Eye Visual acuity Detachment configuration CCT (μm) First treatment Second treatment Final CCT (μm) Final visual acuity 1 20/2000 nonpl 876 air tamp air tamp corneal inc. 589 20/50 2 20/1000 pl 823 cons. air tamp. 567 20/40 3 20/60 598 534 20/20 4 20/100 647 524 5 923 546 6 911 566 20/32 7 20/80 615 523 8 planar 850 cons 576 pl = planar, nonpl = nonplanar, cons. = conservative, air tamp. = air tamponade, corneal incs = corneal incision, CCT = central corneal thickness

Results Treatment method 5% NaCl, 0,1% Dexamethasone, 1% Tropicamid, ofloxacin anterior chamber tamponade 1 ml filtered air topical anesthesia air tamponade ab externo stab incision in the mid-peripheral area

Results monitoring the outcome

Conclusions OCT is very useful in diagnosis and monitoring treatment results of Descemet’s membrane detachment Decisions regarding treatment should be based on the individual features and evaluation of the configuration of the detachment using OCT