Predictors of Repeat Descemetopexy Following Phacoemulsification: Clinical Risk Factors and Descriptive AS-OCT Findings.

PURPOSE: To evaluate clinical features, predisposing factors, detection timing, and AS-OCT characteristics in post-cataract Descemet membrane detachment (DMD) requiring surgical management.

METHODS

Retrospective study of 100 eyes treated between 2018 and 2023. Eyes were grouped as intraoperative detection with single surgery (G1, n=80), intraoperative detection with repeat intervention (G2, n=9), and postoperative detection (G3, n=11).

RESULTS

The mean age of the patients was 71.25±10.47 years; the cohort included 47 female and 53 male patients. DMD was detected intraoperatively in 89 eyes and postoperatively in 11. Predisposing factors were present in 22 eyes. The number of interventions differed among groups (p<0.001), as did the frequency of predisposing factors (p=0.003). Final best-corrected visual acuity was similar across groups (p=0.848), and anatomical success was comparable. Median DMD height and length were similar between G2 and G3 (p=0.056 and p=0.824). Central corneal thickness differed among groups (p<0.001). Predisposing factors were not associated with DMD height, length, or central corneal thickness (p=0.631, p=0.579, and p=0.796). In multivariate logistic regression analysis, the presence of predisposing factors was independently associated with repeat intervention (OR = 13.16, %95 CI: 3.50-49.49; p < 0.001).

CONCLUSIONS

Most intraoperatively detected DMDs resolved with a single procedure. Predisposing factors were linked to repeat intervention despite similar AS-OCT detachment dimensions.