Compression Sutures to Treat Acute Hydrops in a Case of Bilateral Post-Laser In Situ Keratomileusis Ectasia

Abstract

This a case report of acute hydrops with interface fluid syndrome in a patient with post-laser in situ keratomileusis (LASIK) ectasia treated with compression sutures. A patient with post-LASIK ectasia presented with acute hydrops and fluid accumulation in the LASIK flap-stromal interface sequentially in both eyes. Full thickness compression sutures were applied to appose the edges of the Descemet tear, and this resulted in a rapid resolution of stromal edema and interface fluid. The patient had best distance visual acuities of 20/40 and 20/60 at the last follow-up in the right and left eyes, respectively. Hydrops along with fluid in the interface needed early intervention to prevent complications such as epithelial ingrowth and interface haze. Compression sutures were useful in this case to help bridge the gap between the margins of Descemet tear, hastening the resolution of stromal edema and interface fluid.

Management of acute corneal hydrops – Current perspectives

“…This may predispose the patient for development of complications like interface haze and epithelial ingrowth. Management strategies include conservative management if there is no leakage of fluid, drainage of sub-flap fluid followed by air injection and flap suturing if there is leakage,[ 34 71 ] use of compression sutures,[ 72 ] or emergency penetrating keratoplasty in the event of impending or obvious perforation.…”