Dr. RAKHI KUSUMESH

Dr. AMBASTA ANITA, Dr. NILESH MOHAN, Dr.DIVYA KUMARI

Abstract

Background: DALK is a selective keratoplasty procedure indicated for corneal opacities limited to the stroma. Herein, we describe three cases of manual DALK complicated with intraoperative Descemet membrane (DM) perforation and its management with ASOCT assistance. Material and method: A retrospective study evaluated a series of ten eyes that had DALK using layer-by-layer manual dissection technique. Results: Intraoperative DM perforation occurred in three eyes during manual deep dissection. In all eyes, dissection could be completed by forming and maintaining the anterior chamber (AC) with air, suture and fibrin glue. Subsequently, the use of 14% C3F8 enhanced the resolution of residual aqueous. Double AC formation was also encountered in one case following C3F8 which was managed with slit-lamp assisted drainage after localization on ASOCT. Conclusion: Identification and proper management of DM perforation can lead to good visual and anatomical outcome.