Acute corneal hydrops is a pathological condition which clinically presents by marked corneal edema developing due to a break in Descemets membrane. Background. To analyze the results of diagnosis and treatment in patients with acute corneal hydrops. Materials and methods. 42 patients (47 eyes) suffering from acute corneal hydrops were included in the study. This condition appeared on both eyes simultaneously or sequentially in 5 patients. Mean age was 28.7 10.1 years (from 19 to 54 years), 31 men, 11 women. In case of complications or inefficacy of medical therapy surgical procedures were performed: 10% gas (C3F8, SF6) injection into the anterior chamber, amniotic membrane transplantation, partial lamellar keratoplasty, DALK, PKP. Results. Duration of corneal ectasia before acute hydrops occurrence was 12.6 4.6 years. Disease was not diagnosed before in 11.9%. Corneal thickness varied from 692 98 m in focal hydrops to 1200 220 m in total hydrops. Area of edema, height of Descemet detachment and gap between break margins were significantly above in cases of subtotal and total hydrops compared with focal and partial hydrops (2, p 0,001). Injection of 10% gas (C3F8, SF6) in the anterior chamber allowed to significantly accelerating the resolution of this condition in cases of subtotal and total hydrops. Conclusion. Analysis of this case series showed the feasibility of a differentiated approach in the treatment of acute corneal hydrops depending on its severity.