Descemet Membrane Folds Follow-up
- Author: Robert H Graham, MD; Chief Editor: Hampton Roy Sr, MD more...
Further Inpatient Care
- Descemet membrane folds usually are not associated with a condition that requires inpatient care.
- Severe ocular infection with or without pending perforation may require intensive topical medication (every 30 min).
Further Outpatient Care
- The amount of outpatient care needed depends on the underlying cause of inflammation. For instance, inflammation due to corneal infection requires close follow-up care, while Descemet folds from inflammation after routine cataract surgery[7] only need routine follow-up care. If not acute in nature, monthly follow-up care may be warranted.
Inpatient & Outpatient Medications
- Patients should be treated with appropriate medications to treat the underlying cause of inflammation. If infectious, antibiotics are appropriate. The inflammation causing the Descemet folds should be treated with topical steroidal and nonsteroidal drops, unless a contraindication exists. Hypertonic agents also can be used to decrease corneal edema and to improve Descemet folds.
Transfer
- Since these conditions usually do not warrant hospitalization, transfers are unusual.
Deterrence/Prevention
- Minimizing the length of surgery may help reduce the amount of Descemet folds in the acute postoperative period. Avoid intraoperative complications, such as posterior capsular rupture, corneal burns, retained lens fragments, and posterior dislocation of lens material.
- Trauma and ocular injuries, such as chemical splashes, often can be avoided by the use of protective eyewear.
- Most of the time, factors that lead to Descemet folds (eg, infections, inflammatory conditions) cannot be prevented.
Complications
- If corneal inflammation is associated with thinning, then corneal perforation may result. Central corneal scarring also may result depending on the location of the underlying corneal infection or injury.
- Usually, the Descemet folds resolve with the resolution of the ocular inflammation. Depending on the duration of the corneal edema and folds, there may be residual corneal scarring after the edema and folds resolve.
Prognosis
- Patients usually have a good prognosis unless central corneal scarring results. Once the inflammation is treated, the corneal edema and Descemet folds typically resolve.
Patient Education
- Patients usually need reassurance with prolonged use of topical medications. They may find it difficult and tedious to instill the drops as frequently as usually is prescribed. Also, the patient needs to understand that gradual improvement will occur in the inflammation and Descemet folds, which results in gradual improvement of their vision.
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