Full-Thickness Compressive Corneal Sutures with Removal of Anterior Chamber Air Bubble in the Management of Acute Corneal Hydrops

Ashena, Zahra; Mukhija, Ritika; Nanavaty, Mayank A.

doi:10.3390/vision7010010

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…Ashena et al . [ 52 ] used full-thickness compression sutures without intracameral gas/air in five patients. Chaurasia et al .…”

Section: Surgical Strategiesmentioning

confidence: 99%

Management of acute corneal hydrops – Current perspectives

Bafna,

Kalra,

Asif

et al. 2024

Indian Journal of Ophthalmology

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Acute corneal hydrops (ACH) is a rare but sight-threatening complication of corneal ectasias. We aim to review the current literature on etiopathogenesis, histology, role of ancillary investigations, management, and outcomes of ACH by classifying the various management strategies based on their site of action and the underlying mechanism. A review of the literature was conducted by searching the following databases: PubMed (United States National Library of Medicine), Embase (Reed Elsevier Properties SA), Web of Science (Thomson Reuters), and Scopus (Elsevier BV) till April 2023. The literature search used various combinations of the following keywords: acute corneal hydrops, keratoconus, ectasia, management, keratoplasty. Nine hundred eighty-three articles were identified based on the above searches. Case reports which did not add any new modality of treatment to the existing literature, articles unrelated to management, those with no full text available, and foreign-language articles with no translation available were excluded. Eventually, 75 relevant articles that pertained to the management of ACH were shortlisted and reviewed. Recent studies have described newer surgical interventions like full-thickness or pre-Descemetic sutures, thermokeratoplasty, and plasma injection that aim to close the posterior stromal break. Posterior lamellar keratoplasties act by replacing the posterior torn Descemet’s membrane (DM), and early deep anterior lamellar keratoplasty (DALK) has been attempted to combine the correction of the anatomical defect and visual rehabilitation in a single surgery. These surgical interventions may help by reducing the scarring and increasing the number of patients who can be visually rehabilitated with contact lenses rather than keratoplasty.

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“…Ashena et al . [ 52 ] used full-thickness compression sutures without intracameral gas/air in five patients. Chaurasia et al .…”

Section: Surgical Strategiesmentioning

confidence: 99%

Management of acute corneal hydrops – Current perspectives

Bafna,

Kalra,

Asif

et al. 2024

Indian Journal of Ophthalmology

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“…[1][2][3][4] Surgical treatments that promote DM reapproximation include compression sutures, DM endothelial keratoplasty patch graft, full-thickness corneal incisions, and intracameral gas (eg, air or isoexpansile inert gas) tamponade. [5][6][7][8][9][10][11][12][13] Intracameral gas tamponade has the most reported evidence, and time to visual recovery may be reduced. 13 However, if the detached DM has a taut configuration, gas alone may not reapproximate the detachment.…”

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confidence: 99%

Relaxing descemetotomy: microscope-integrated OCT-guided technique for acute corneal hydrops

Kanu,

Qureshi,

Cherny

et al. 2024

JCRS Online Case Rep

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Introduction: 3 cases are used to illustrate the technique of Descemet membrane (DM) relaxing incisions followed by air descemetopexy for the management of patients with acute corneal hydrops. Patients and Clinical Findings: In each case, anterior-segment optical coherence tomography (OCT) demonstrated taut DM detachments and hydrops was refractory to conservative medical management and intracameral air injection. Diagnosis, Intervention, and Outcomes: To facilitate the reapproximation of DM and potentiate corneal deturgescence, intraoperative OCT-guided descemetotomy was performed with bent surgical scissors and a bent 30-gauge needle. Subsequent air descemetopexy was successful, and DM reattachment was maintained postoperatively. Corneal edema improved in all patients relatively rapidly postoperatively. Conclusions: Relaxing descemetotomy with air descemetopexy may be useful in cases of acute corneal hydrops with taut DM detachments that are unresponsive to air tamponade alone.

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Strategies and Application of Compression Sutures With a Modified Technique for Rapid Resolution of Large (Grade III) Hydrops: A Prospective Interventional Study

Daza,

Ramappa,

Murthy

et al. 2025

Cornea

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Purpose: The aim of this study was to describe the strategies and outcomes, with a modified technique, of compression sutures in large acute hydrops. Methods: This was a prospective interventional study in 29 eyes of 28 patients who underwent compression sutures using a modified technique. The degree of resolution after surgical intervention was quantified by 3 masked observers, using the slit-lamp photographic documentation and optical coherence tomography. The degree of resolution, best-corrected visual acuity, and complications were analyzed. Results: The mean age was 20.89 (7–46) years. Five patients had pellucid marginal degeneration (pellucid marginal corneal degeneration), 23 had keratoconus, and 1 had posttrauma hydrops. The preoperative visual acuity was hand motions in all eyes. The reduction in edema was 76% on day 1, 91.6% on 6 ± 2 days, 98.6% on 18 ± 3 days from surgical intervention. The baseline pachymetry assessed on optical coherence tomography was beyond measurement in 26 eyes. The mean pachymetry at day 1 was 704 μm (range 480–950) which reduced to 607 (range 422–850) microns at 6 ± 2 days and 518 (range 415–718) microns at 18 ± 3 days postintervention (P < 0.0001). The mean duration between the surgery and complete suture removal was 48 (35–68) days. No suture-related complications were noted. Twenty eyes could attain good visual rehabilitation with glasses/contact lenses (vision could not be assessed in 5 eyes). Penetrating keratoplasty was performed on 1 patient. Conclusions: Compression sutures using the modified technique was safe and effective in the rapid resolution of acute hydrops in keratoconus and pellucid marginal corneal degeneration. No complications were noted, and visual restoration with spectacles and contact lenses was satisfactory.

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Full-Thickness Compressive Corneal Sutures with Removal of Anterior Chamber Air Bubble in the Management of Acute Corneal Hydrops

Cited by 3 publications

References 22 publications

Management of acute corneal hydrops – Current perspectives

Management of acute corneal hydrops – Current perspectives

Relaxing descemetotomy: microscope-integrated OCT-guided technique for acute corneal hydrops

Strategies and Application of Compression Sutures With a Modified Technique for Rapid Resolution of Large (Grade III) Hydrops: A Prospective Interventional Study

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