Corneal Hydrops in Keratoconus: Role of compression suture with intracameral air – A case series

Abstract

Introduction: Acute corneal hydrops (ACH) is a vision threatening complication of advanced keratoconus caused by tear in Descemet membrane, leading to sudden stromal edema, pain, photophobia and marked visual impairment. Although many cases resolved with conservative management, prolong edema may cause dense corneal scarring and eventually need for keratoplasty. Compression suture aimed at accelerating rapid resolution of edema, reattachment of the Descemet tear, shorten recovery time and improve visual outcome. Purpose: To assess the clinical outcome and effectiveness of compression suture technique in acute corneal hydrops in keratoconus. Method: This retrospective case series include five eyes of five patients with keratoconus presenting with acute hydrops. All patient underwent partial thickness corneal suturing placement over the area of Descemet’s membrane break with intracameral air injection. Pre – and post-operative best corrected visual acuity (BCVA), slit-lamp findings and anterior segment optical coherence tomography (AS-OCT) were analyzed. Results: All five patients showed resolution of symptoms and corneal oedema between 15-40 days post operatively with faint central scar in 3 patients. BCVA improved between 0.6 to 1.0 logMAR. Central corneal thickness (CCT) decreased significantly, between 480 and 670 μm. Conclusion: Compression sutures with intracameral air helps to early resolution of corneal edema, minimize the residual scarring, enhance visual recovery, and may help to defer the need for corneal transplantation. Conclusion: Compression sutures with intracameral air helps to early resolution of corneal edema, minimize the residual scarring, enhance visual recovery, and may help to defer the need for corneal transplantation. 

Medivision J. of Med. and Health Sci. Vol 1(1), Jul 2026; p 80-84