Purpose
To report 4 cases of undiagnosed Descemet membrane detachment (DMD). Ophthalmologists should always look for DMD in any case of post cataract surgery persistent corneal edema. Early management of DMD with air descemtopexy could spare the patient a penetrating keratoplasty (PK).

Methods
All 4 cases were referred for management of persistent corneal edema (case 1,2) and corneal scarring (case 3,4). Cases 1 and 2 presented 1 month after cataract surgery while cases 3 and 4 presented 3 months and 1 year after surgery respectively. Cases 1-3 had visible DMD on presentation while case 4 had dense scarring. Cases 1 and 2 underwent air descemtopexy and 1 week of postoperative supine positioning while cases 3 and 4 underwent PK. DMD was diagnosed intraoperatively in case 4. Cases 1 and 4 had Fuch's Ednothelial Dystrophy (FECD) in the other eye.

Results
Cases 1 and 2 had complete resolution of corneal edema within 1-2 weeks after air descemetopexy with improvement of best corrected visual acuity BCVA to 6/60 and 6/12 respectively. Cases 3 and 4 improved to BCVA of 6/60 and 6/36 3 and 1 months postoperative respectively.

Conclusion
DMD is frequently overlooked as a cause of post cataract surgery corneal edema. DMD can be easily corrected with air descemetopexy. DMD can lead to significant corneal scarring within 3 months postoperative necessitating a PK for visual improvement. Patients with FECD are particularly vulnerable to DMD due to easy separation of Descemet membrane.