Rapid Resolution of Large and Non- Resolving Corneal Hydrops using a modified technique of compression sutures

ABSTRACT

Purpose

To report rapid resolution of corneal clearing with the application of a modified technique of compression sutures in large hydrops.

Methods

Interventional case series of seven patients.

Results

Three patients had acute hydrops secondary to keratoconus, three had pellucid marginal corneal degeneration and another one had ectasia of undetermined etiology. A thorough slit-lamp evaluation and anterior segment optical coherence tomography was performed. The surgical technique involved paracentesis, anterior chamber decompression, compression suture placement within the stroma against the background of partial air fill in the anterior chamber, and bandage contact lens application. All eyes showed a remarkable reduction in corneal edema at 1 h (documented in four eyes) and 1 day (documented on the rest), which continued to improve in further follow up.

Conclusions

The modified technique of compression sutures facilitate rapid recovery of corneal edema in acute hydrops seen in keratoconus and pellucid marginal corneal degeneration. The physiologic basis is akin to the external tamponade achieved with buckle in retinal detachment surgeries.

KEYWORDS:

• Acute hydrops
• keratoconus
• descemetopexy
• Compression sutures
• Corneal endothelium

Author Contributions

The corresponding author states that authorship credit of this manuscript was based on 1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; 2) drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published. All listed authors met conditions 1, 2, and 3. All persons designated as authors qualify for authorship, and all those who qualify are listed. Each author has participated sufficiently in the work to take public responsibility for appropriate portions of the content.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Hyderabad Eye Research Foundation.