Lens & Cataract-Descemet's Folds

Corneal edema with Descemet's folds after phacoemulsification surgery.

Clinical features:
- Very common finding especially in the first week postoperatively
- May also occur following other intraocular surgeries such as corneal transplant, glaucoma and posterior chamber procedures
- The folds can be visualized as dark, deep-appearing, criss-cross lines in the posterior stroma and Descemet's membrane associated with a hazy or mild loss of stromal transparency due to corneal edema
- Normally, the edema will resolve over several weeks. However, the condition may be irreversible in eyes with preexisting endothelial dystrophies or low endothelial cell density
Possible causes: endothelial cell loss during surgery, anterior chamber irrigation, intraocular manipulation or mechanical trauma from surgical instruments or intraocular lenses.
Management:
- Postoperative evaluation is essential to rule out possible corneal endothelial trauma, Descemet's membrane tear by the surgical instruments or postoperative inflammation.
- Topical corticosteroids to reduce inflammation reaction that might contribute to further endothelial damage.

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