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Chapter-25 Pre-descemetocele

BOOK TITLE: Pre-Descemet’s Endothelial Keratoplasty (PDEK)

Author
1. Agarwal Amar
2. Narang Priya
ISBN
9789352703036
DOI
10.5005/jp/books/14154_26
Edition
1/e
Publishing Year
2018
Pages
5
Author Affiliations
1. Eye Research Centre and Dr. Agarwal’s Group of Eye Hospitals, Chennai, Bangalore, Trichy, Jaipur, Salem, Kerala, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral Road Chennai, Tamil Nadu, India, Dr Agarwal’s Eye Hospital, 9, Cathedral Road, C,hennai, India, Dr Agarwal’s Eye Institute, 13 Cathedral Road, Chennai, India, Dr. Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, India, 15 Eagle Street, Langford Town Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl Road, Dubai PB 9168, Dubai, Dr. Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, India, 15 Eagle Street, Langford Town Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl Road, Dubai PB, Dubai, Dr Agarwal’s Group of Eye Hospitals, and Eye Research Centre, Chennai, India., Dr. Agarwal’s group of eye hospitals at Chennai, Bangalore, Jaipur, Salem and Trichy, India, Dr. Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai-600086, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre 19,
2. Narang Eye Clinic, Ahmedabad (India), Narang Eye Clinic, Ahmedabad, India, M and I Institute of Ophthalmology, Ahmedabad, Narang Eye Hospital, Ahmedabad, Gujarat, India, Narang Eye Hospital Ahmedabad, Gujarat, India, Narang Eye Care and Laser Center, Ahmedabad, Gujarat, India
Chapter keywords
Pre-descemetocele, pre-Descemet\'s layer, PDL, Descemet’s membrane, optical coherence tomography, OCT, phacoemulsification

Abstract

This chapter presents a glimpse on pre-descemetocele. The surgeon comes across descemetocele in cases of progressive corneal ulceration or degeneration that starts with a defect in the corneal epithelial layers and eventually progresses to involve the stroma with an intermediate stage of descemetocele followed eventually by corneal perforation. In clinical practice, it has been demonstrated that some descemetoceles resist perforation better than others. This is probably due to the presence of an additional layer of pre-Descemet\'s layer (PDL) that has been demonstrated to withstand a high pressure of 700 mm of Hg in donor corneas. A descemetocele when covered with a PDL should be correctly designated as a pre-descemetocele. Loss of PDL leads to baring of DM that eventually ruptures.

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