Late corneal hydrops after penetrating keratoplasty for keratoconus

To report 2 cases of corneal hydrops occurring in eyes with previously healthy corneal grafts.

Retrospective case series. A report of 2 presenting cases. Both patients underwent a full ophthalmic clinical examination and anterior segment optical coherence tomography (OCT).

Two patients with longstanding corneal grafts for keratoconus presented with an acute painful red eye and reduced vision. They were found to have acute hydrops with breaks in and detachments of Descemet membrane.

Keratoconic patients with longstanding corneal grafts who present acutely with corneal edema must be carefully examined not only for signs of graft rejection or failure but also for acute hydrops. Important differentiating signs may be a Descemet break or detachment and the presence of stromal edema across the donor-host corneal interface.