Descemet Membrane Detachment due to Laser Application in Femtosecond Laser-Assisted Cataract Surgery: Incidence and Risk Factors

PURPOSE: To assess the incidence and risk factors of Descemet membrane detachment due to laser application in femtosecond laser-assisted cataract surgery (FLAGS). METHODS: In this retrospective case series, all patients who underwent FLAGS with the LenSx system (Alcon Laboratories, Inc) were eligible to participate. The medical records were reviewed to collect data regarding potential risk factors related to Descemet membrane detachment, including patient's demographics, Laser parameters, and ocular measurements. The eyes were separated into two groups based on the clinical diagnosis of Descemet membrane detachment as the femtosecond laser was performing the corneal incisions. RESULTS: Five hundred ten eyes (304 patients) were included. Descemet membrane detachment occurred in 20 13.9%) eyes of 16 (5.3%) patients. Four (1.3%) patients had a detachment in both eyes. In 16 (3.1%) eyes, the Descemet membrane detachment occurred in the secondary incision site. The eyes that had a detachment had a statistically lower mean endothelial cell density (2,193.40 +/- 313.37 versus 2,385.08 +/- 357.80 cells/mm(2); P = .019), and a statistically higher prevalence of corneal guttata (25.0% versus 8.8%; P = .015). None of the other analyzed variables statistically differed between the groups (P > .051. The risk of having Descemet membrane detachment was statistically higher among eyes with guttata (odds ratio = 3.47; P = .015) and in those with an endothelial cell density of less than 2,000 cells/mm(2) (odds ratio = 3.26; P = .014). CONCLUSIONS: The incidence of Descemet membrane detachment due to laser application in FLACS was 3.9%, with the associated risk factors being endothelial cell density of less than 2,000 cells/mm(2) and corneal guttata.