LAUSR

A 60-year-old lady underwent an uncomplicated extracapsular cataract extraction (ECCE). On first post-op day, she had a vision of 20/200 with edema on superior 1/3rd of cornea. Slit-lamp examination revealed localized stromal edema with Descemet’s membrane folds in main incision area reaching upper border of pupil [Fig. 1a]. It was assumed that the edema was due to Descemet’s Membrane Detachment (DMD). After 1 week, edema had slightly decreased with an improvement in visual acuity to 20/40 after administration of topical prednisolone-acetate 1% and sodium chloride 5%. On repeat slit-lamp examination, a refractile membrane with a well-defined margin was seen closely adhered to the endothelium [Fig. 1b]. UBM showed a separate membrane lying almost clinging to the endothelium, but no detachment of descent’s membrane was identified [Fig. 1c]. Hence, what was assumed to be DMD turned out to be a retained anterior capsule. After the removal of anterior capsule in OT, edema subsided within a week with BCVA 20/30 [Fig. 1d]. Thus, though DMD remains one of the commonest complications[1] and causes of persistent corneal edema post-cataract surgery, it remains important for us to look for any other possible cause responsible for the condition. With the new imaging modalities[2] like AS-OCT and UBM, the detection of the pathology causing post-op corneal edema has become easier.