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Cornea ; 36(3): 375-376, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28129290

ABSTRACT

PURPOSE: To describe the clinical signs of Descemet membrane (DM) detachment due to forceps-related birth injury and its subsequent management using optical coherence tomography. METHODS: Case report. RESULTS: A 3-day-old term infant presented with left eye corneal clouding and a definitive history of traumatic forceps-assisted delivery. Despite topical therapy, corneal clouding persisted, necessitating an examination under anesthesia using ultrasound and handheld optical coherence tomography. This revealed not only a tear in DM but also a large detachment. Injection of air alone failed to achieve apposition of DM to the posterior stroma. Apposition was achieved only after penetration of the overlying cornea with the needle of a 10-0 nylon suture and release of clear viscous fluid. The cornea cleared within the first week and continued in the months to follow. CONCLUSIONS: Prolonged corneal edema should alert the physician to probable DM detachment after forceps-related birth injury. Injecting air alone may not be sufficient to reattach the detached DM.


Subject(s)
Birth Injuries/surgery , Corneal Edema/surgery , Corneal Opacity/surgery , Descemet Membrane/injuries , Eye Injuries/surgery , Obstetrical Forceps/adverse effects , Birth Injuries/diagnostic imaging , Birth Injuries/etiology , Corneal Edema/diagnostic imaging , Corneal Edema/etiology , Corneal Opacity/diagnostic imaging , Corneal Opacity/etiology , Descemet Membrane/diagnostic imaging , Eye Injuries/diagnostic imaging , Eye Injuries/etiology , Follow-Up Studies , Humans , Infant, Newborn , Male , Ophthalmologic Surgical Procedures , Tomography, Optical Coherence
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