Dr. RAKHI KUSUMESH

DR. NILESH MOHAN, DR DIVYA KUMARI

Abstract

Objective: DALK is a selective corneal transplantation procedure indicated for corneal opacities limited to stroma. The most common intraoperative complication is a perforation. Here we describe two cases of manual DALK complicated with intraoperative Descemet membrane (DM) perforation at the time of stromal removal using layer-by-layer manual dissection technique. The dissection could be completed by forming and maintaining the anterior chamber (AC) with air and suture. Subsequently the use of 14% C3F8 enhanced the resolution of residual aqueous. Double AC formation was also encountered in one case following C3F8 which was managed with slit-lamp assisted drainage after localization on ASOCT. So, DM perforation was managed and monitored using appropriate measures with ASOCT assistance. Conclusion: Identification and proper management of DM perforation lead to good visual and anatomical outcome.