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March 1978

Dull Knives and Descemet's Membrane Detachments-Reply

Author Affiliations

Astoria, NY

Arch Ophthalmol. 1978;96(3):542. doi:10.1001/archopht.1978.03910050300028

In Reply.  —Dr Payne's experience has not been unique. In the past halfcentury many previous authors,1-8 to whom we referred in our original article, have recognized that postoperative detachments of Descemet's membrane (DM) frequently result from improper instrumentation, especially dull keratomes or blades. We saw no need to restate these opinions (with which we agree) and preferred to report the original findings that we documented with slit-lamp photographs.Incidentally, the bilateral occurrence of these detachments in uneventful operations has caused several observers3,6,9 to comment on the probable predisposition of such patients to this complication, in the absence of surgical error. In our report, we stated that the only patient on whom one of us (S.J.H.) operated, had bilateral cataract extractions and bilateral detachments of DM without knife-entry difficulties. That the 360° annular detachment patterns with sparing of the centermost cornea are caused by any instrumentation would also seem

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