Spontaneous Resolution of Extensive Descemet Membrane Detachment Caused by Sodium Cyanide Injury to the Eye

PURPOSE: To describe the clinical course, ultrasonographic and confocal microscopic findings in a patient who developed a large Descemet membrane (DM) detachment that resolved spontaneously after ocular sodium cyanide injury. METHODS: Case report. RESULTS: The patient presented with severe corneal stroma edema, a large detachment of DM, iritis, and anterior subcapsular lens opacity in the left eye caused by contact with 5% sodium cyanide. The ultrasound biomicroscopic and in vivo confocal microscopic examination exhibited the configuration of the DM detachment and extensive damage of corneal cells. Although no viable endothelial cells were observed with in vivo confocal microscopy, the DM spontaneously reattached 11 days after injury, coincident with increased intraocular pressure. However, persistent corneal edema and iris atrophy were observed 6 months after DM reattached. CONCLUSIONS: Sodium cyanide can cause severe injuries to the cornea and the anterior segment. Extensive DM detachment may resolve spontaneously despite the absence of viable endothelial cells.