Management of acute corneal hydrops with intracameral gas injection

Sayadi, Jamasb; Lam, Helene; Lin, Charles C.; Myung, David

doi:10.1016/j.ajoc.2020.100994

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…The authors injected intracameral SF6 to tamponade the detached Descemet and achieved good results [ 10 ]. Venting incisions to compress the stromal fluid combined with intracameral injection of 20% SF6 was successfully tried in another study [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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

Ashena

Mukhija

Nanavaty

2023

Vision

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Acute hydrops is a rare complication of corneal ectatic disease, which occurs secondary to Descemet membrane break. Spontaneous resolution of this condition is associated with longstanding ocular discomfort and corneal scar. Intracameral gas/air injection with or without corneal suturing, anterior segment ocular coherence tomography (ASOCT)-guided drainage of intrastromal fluid, and penetrating keratoplasty are some of the described surgical interventions to manage this condition. The purpose of our study was to assess the effect of full-thickness corneal suturing as a solo treatment in the management of acute hydrops. A total of five patients with acute hydrops received full-thickness corneal sutures perpendicular to their Descemet break. A complete resolution of symptoms and corneal oedema was observed between 8 to 14 days post-operation with no complications. This technique is simple, safe, and effective in the management of acute hydrops and saves patients from a corneal transplant in an inflamed eye.

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Section: Discussionmentioning

confidence: 99%

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

Ashena

Mukhija

Nanavaty

2023

Vision

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“…Various therapeutic options (medical or surgical interventions or conservative methods) were introduced to reduce patients' symptoms or shorten the healing period. These options include intracameral gas injection (air, sulfur hexafluoride (SF6) or perfluoropropane (C3F8)) to produce a gas tamponade or compression sutures such as pre-Descemet's membrane sutures [3][4][5]. Among the conservative approaches is the use of hypertonic saline eye drops/ ointments or antiglaucoma agents, which helps to improve the condition by drawing fluid from the cornea or reducing the hydrodynamic pressure on the back surface of the cornea, respectively [6].…”

Section: Introductionmentioning

confidence: 99%

Acute Hydrops with Total Corneal Edema in a Very Young Child with Keratoconus: The Youngest Age Reported Case

Sedaghat

Momeni‐Moghaddam

Belin

et al. 2022

Case Reports in Ophthalmological Medicine

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Purpose. To present the youngest age ever reported for acute corneal hydrops with total corneal edema in a child with advanced bilateral keratoconus. Methods. Patient presentation in ophthalmic clinic. The patient underwent various clinical tests and examinations including anterior segment optical coherence tomography (AS-OCT) and Scheimpflug corneal tomography. Results. A 5-year-old girl presented with uncorrected distance visual acuity (UDVA) of 0.4 in the right eye and nonmeasurable UDVA associated with severe photophobia in her left eye of a 3-day duration. Intraocular pressure using the iCare tonometer was 14 and 5 mmHg in the right and left eyes, respectively. An old corneal hydrops scar and posterior subcapsular cataract (PSC) in the right eye and a total limbus to limbus corneal hydrops in the left eye were observed on slit-lamp examinations. Scheimpflug corneal tomography was possible in the right eye but, due to excessive irregularity and scaring, was not possible in the left eye. Corneal thinning and scarring were evident in the anterior segment optical coherence tomography in the right eye and very edematous cornea associated with stromal cleft and epithelial bullae in the left eye. A management plan consisting of topical hypertonic solution and ointment was started to reduce her symptoms. Conclusion. Acute corneal hydrops may be the presenting sign of keratoconus; however, extensive hydrops involving the total cornea area at a very young age is very rare and has not been previously reported in the literature.

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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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Management of acute corneal hydrops with intracameral gas injection

Cited by 4 publications

References 8 publications

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

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

Acute Hydrops with Total Corneal Edema in a Very Young Child with Keratoconus: The Youngest Age Reported Case

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

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