Intraoperative OCT observation of incision-related descemet membrane detachment during implantable collamer lens implantation
Year: 2026
Type: article
Study design: Observational Study
Abstract: Purpose The occurrence of Descemet membrane detachment (DMD) during each surgical step of implantable Collamer lens (ICL) surgery for phakic eyes using intraoperative OCT navigation microscope, and to analyze the factors influencing DMD. Methods The single-center retrospective case series included 100 eyes of 50 patients aged 21 to 38 years with refractive errors from July to October 2024, and all patients underwent ICL surgery with a 3.0 mm steep-axis surgical incision. During the operation, the intraoperative OCT navigation microscope was used to observe at each step whether the DMD occured at the incision site and whether the range of detachment changed in subsequent steps. Results All procedures were completed successfully without intraoperative complications. No DMD was detected by the end of incision creation. The cumulative number of eyes in which DMD had been detected increased to 21 (21%) by the end of ICL insertion, 34 (34%) by the end of ICL positioning, and 45 (45%) by the end of irrigation/aspiration of the viscoelastic agent. In the mixed-effects analysis accounting for the correlation between fellow eyes, lower preoperative intraocular pressure was associated with higher odds of DMD occurrence (odds ratio per 1-mmHg increase, 0.77; 95% CI, 0.61–0.97; P = 0.03). None of the evaluated factors was significantly associated with DMD extent. Conclusion Intraoperative OCT enabled real-time detection of incision-related DMD developing or extending during ICL surgery. The cumulative occurrence of DMD increased as the procedure progressed, supporting careful instrument manipulation and minimization of repeated contact with the corneal incision throughout surgery.
Source: Frontiers in Medicine
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7222202876