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March 1965

Stripping of Descemet's Membrane in Cataract Extraction

Author Affiliations

From the Department of Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia General Hospital, Veterans Administration Hospital and the Children's Hospital of Philadelphia.

Arch Ophthalmol. 1965;73(3):311-314. doi:10.1001/archopht.1965.00970030313003

This paper describes three eyes in which Descemet's membrane was inadvertently stripped from the cornea during cataract extraction. In all eyes the mishap passed unnoticed at the time of surgery, and was recognized only days or weeks later when a corneal opacity was noted that simulated the appearance of epithelial downgrowth.

Stripping of Descemet's membrane to a lesser degree is not rare. Strips of Descemet's membrane, which appear as curly tags of transparent tissue, can often be seen along the inner aspect of corneal incisions or perforations of any type. More extensive separation of Descemet's membrane frequently occurs with cyclodialysis. The author has seen several patients with permanent localized corneal edema and small epithelial blebs overlying areas where Descemet's membrane had been stripped by a cyclodialysis spatula during cyclodialysis. The edema can progress to painful bullous keratopathy with discomfort and loss of vision. Separation of Descemet's membrane from the cornea