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Corneal Endothelial Avulsion Due to Incision-Related Descemet Membrane Detachment (DMD) During Phacoemulsification

DMD at the incision site with phacoemulsification is more common among inexperienced surgeons and in patients with hard nuclear age-related cataract. Severe DMD can lead to postsurgical corneal edema, endothelial avulsion (as shown in this video), and corneal decompensation requiring corneal transplantation.

A clinical trial comparing modified (enlarged internal width to 3.0 mm) or conventional (2.2 mm) incision phacoemulsification with intraocular lens implantation reported that modified phacoemulsification with trapezoid incision reduced the incidence of incision-related DMD at postoperative day 1.

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