Partial-thickness compression sutures without descemetopexy for management of acute hydrops in keratoconus: A novel surgical technique

Jain, Neha; Shah, Vishwa; Mittal, Vikas; Yadav, Vipul

doi:10.4103/ijo.ijo_2085_22

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Jain et al . [ 51 ] described partial-thickness compression sutures without air/gas injection in a couple of patients and achieved good vision in follow-up. Ashena 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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“…Jain et al . [ 51 ] described partial-thickness compression sutures without air/gas injection in a couple of patients and achieved good vision in follow-up. Ashena 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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“…Both partial and fullthickness compression sutures with descemetopexy, are very effective for the management of acute hydrops in keratoconus. 11,12 We hereby report a technique of partialthickness compression suturing with air descemetopexy for DMD during cataract surgery.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative partial thickness compression suturing for descemet’s membrane detachment: A Novel technique

Raj,

Raj

2024

IJOOO

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: To evaluate the efficacy of partial thickness transcorneal compression suturing with air desmetopexy in descemet’s membrane detachment (DMD) during cataract surgery: This is a retrospective review of records of patients who were managed for non-planar DMDs during phacoemulsification or small incision cataract surgery with partial thickness suturing with air descemetopexy in virgin eyes. : A total of fifteen cases were identified including 11 females and 4 males with average age of 67 years. All patients involved in the study underwent uneventful cataract surgery. All 15 cases involved in the study with DMD during cataract surgery were caused by intra-operative trauma during different instrumentations. Five cases had peripheral DMDs and ten cases had central DMDs. The average size of non-planar DMD was 4 mm. Ten cases had DMDs with scrolled margins. Eight patients achieved the best corrected visual acuity (BCVA) of 6/6 at the end of one month with clear corneas. Descemet’s membrane (DM) got completely attached at two weeks follow-up. The suture removal was done approximately after one month of follow-up. : Partial thickness transcorneal compression suturing with air desmetopexy in non-planar DMD is very helpful in recovering traumatic corneal edema during cataract surgery.

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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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Partial-thickness compression sutures without descemetopexy for management of acute hydrops in keratoconus: A novel surgical technique

Cited by 4 publications

References 17 publications

Management of acute corneal hydrops – Current perspectives

Management of acute corneal hydrops – Current perspectives

Intraoperative partial thickness compression suturing for descemet’s membrane detachment: A Novel technique

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

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