This review seeks to evaluate anterior segment optical coherence tomography (AS-OCT) in the diagnostic procedure and management of Descemet's membrane detachment (DMD) in cataract surgery. DMD may present diagnostic challenges, particularly in pronounced corneal edema where traditional methods such as slit lamp biomicroscopy may be inadequate in evaluating the corneal layers. The role of AS-OCT in providing high-resolution images in the preoperative, intraoperative, and postoperative phases of cataract surgery is analyzed with a focus on its role in the early diagnosis of DMD and in evaluating the extent, morphology, and topographic localization of DMD allowing for immediate intervention during surgery and precise pneumodescemetopexy procedures where conservative treatment has failed. This review explores the integration of AS-OCT into the standard perioperative diagnostic workflow, highlighting its potential role in the prevention, accurate diagnosis, and prompt management of DMD, a complication of cataract surgery that, while low in incidence, can be highly disruptive when it occurs. The emerging role of artificial intelligence (AI) in AS-OCT analysis of anterior segment conditions and surgical procedures is discussed, though refinement of AI algorithms is warranted.