Predescemetocele: A distinct clinical entity

• Main Authors: Priya Narang, Amar Agarwal, Dhivya Ashok Kumar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Deep anterior lamellar keratoplasty; descemetocele; penetrating keratoplasty; pre-Descemet's endothelial keratoplasty; pre-Descemet's layer; predescemetocele
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2017;volume=65;issue=11;spage=1224;epage=1226;aulast=Narang

The case report incorporates a Fourier-domain optical coherence tomography (OCT) examination for demonstration of the existence of pre-Descemet's layer (PDL; Dua's layer) overlying a descemetocele and demonstrates predescemetocele as a separate clinical entity. The prospective analysis was done in two cases that had descemetocele, and OCT demonstrated the presence of PDL over an unruptured descemetocele that offers resilience and can be treated with an elective deep anterior lamellar keratoplasty or a penetrating keratoplasty. A descemetocele, when covered with PDL, should be correctly designated as a predescemetocele. Loss of PDL leads to baring of Descemet's membrane that eventually ruptures.