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Descemet's membrane may be layered in structure
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ATHENS — Small bubbles detected in some cases within Descemet's tissue after deep anterior lamellar keratoplasty with the big bubble technique may reveal some unknown anatomical aspects of the Descemet's structure, according to one surgeon.
"The Descemet's membrane may not be a uniform structure but be internally divided in layers," said Jörg Krumeich, MD, during Cornea Day at the ESCRS Winter Refractive Surgery Meeting.
In more than one case, after performing DALK with the big bubble technique, he observed bubbles that were not part of the anterior chamber bubble, but were inside Descemet's membrane.
"At first I thought they were inside the anterior chamber, but they did not move, and slit lamp examination showed that there were not one but two lines at the Descemet's level," Dr. Krumeich said. "In other words, some air had penetrated inside the Descemet's and split it into two layers."
These bubbles disappeared within 1 day, he said.
This discovery, he noted, "could be of some clinical relevance." Splitting of Descemet's membrane by big bubble injection only occurs by chance in some cases, but one of the implications might be a higher risk of perforation, he said.