A rare case of delayed post-operative migration of intracameral perfluoropropane into pre-descemet space causing a re-detachment of descemet membrane

Abstract

Purpose

To report a case of re-detachment of descemet membrane subsequent to delayed post-operative migration of intracameral perfluoropropane (C3F8) into the pre-descemet space.

Methods

A post-phacoemulsification descemet membrane detachment (DMD) was treated by performing descemetopexy using intracameral C3F8 (14%). The descemet membrane was attached on the first post-operative day and there was a single intracameral gas bubble. However, at one week, there was a second gas bubble noted in the pre-descemet space and the descemet membrane had detached again. A stromal vent incision was used to release the C3F8 gas in pre-descemet space and intracameral C3F8 was injected again to facilitate attachment.

Result

Slit lamp evaluation revealed an attached descemet membrane on the first day following the stromal vent incision with repeat intracameral gas injection. At one week, the corneal edema cleared and best-corrected visual acuity (BCVA) improved to 20/40.

Conclusion

Delayed post-operative migration of intracameral C3F8 may occur causing a re-detachment of the descemet membrane. Stromal vent incisions can be used to drain pre-descemet gas bubble and re-injection of C3F8 intracamerally to facilitate re-attachment.