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Table 1 Summary of cases of Descemet’s membrane detachment after ocular chemical injuries in literature and our study

From: Tractional Descemet’s membrane detachment after ocular alkali burns: case reports and review of literature

Article

Yuen HK 2004

Zhang B 2012

Najjar DM 2004

Najjar DM 2004

Hua MT 2010

Case 1 in our report

Case 2 in our report

Age

40

19

49

45

26

44

28

Gender

Male

Male

Male

Female

Male

Male

Male

Chemical

hydrogen peroxide

sodium cyanide

sodium hydroxide

unknown

ammonia

sodium hydroxide

sodium hydroxide

Onset

3 days

4 days

4 months

4 months

2 months

6 weeks

5 weeks

Location

inferior

Extensive

inferior

inferior

Inferior

inferonasal

inferior

Exam

Slit lamp

UBM

Slit lamp

Slit lamp

Slit lamp

AS-OCT

AS-OCT

Initial VA

HM

20/800

20/80

20/800

HM

HM

20/200

Hyphema

No

No

Yes

Yes

Yes

No

No

Management

Intracameral 20% SF6 injection

1% prednisolone and 0.5% levofloxacin eye drops

Intracameral 18% SF6 injection

unknown

Intracameral air bubble injection

Intracameral 12% C3F8 Intracameral

1% prednisolone and 5% NaCl eye drops

Outcome

reattached

reattached

unresponsive

unknown

unknown

unresponsive

unresponsive

Final VA

20/30

20/100

20/400

unknown

unknown

20/50

HM

Proposed mechanism

hydrogen peroxide penetrated and formed gas anterior to DM

Severe cellular damage in the stroma and endothelial layer

1) an inflammatory retrocorneal membrane associated with an organizing hyphema that pulled on DM leading to its detachment.2) retrocorneal membrane develop neovascularization that rupture and fill the space between DM and stroma

Not proposed

contraction of fibrous exudates pulls on the iris and DM together to its detachment

Associated evidences

gas bubble between corneal stroma and Descemet membrane.

no normal keratocytes /endothelial cells could be detected by in vivo confocal microscopy

a thickened, detached DM associated with a hyphema

Accompanied with hyphema

AS-OCT showed that the detached DM was thick and adherent to the iris. There is no hyphema

  1. VA visual acuity; HM hand movement; DM Descemet’s membrane; AS-OCT anterior segment optical coherence tomography