Acute corneal hydrops in keratoconus - new perspectives

Area of Science:

• Ophthalmology
• Corneal Diseases
• Keratoconus Research

Background:

• Acute corneal hydrops is a complication of keratoconus, involving corneal edema from a break in Descemet membrane.
• While often self-limiting, it can lead to vision-impairing scars and necessitate corneal transplantation.

Purpose of the Study:

• To review current knowledge on the epidemiology, pathogenesis, imaging, and treatment of acute hydrops in keratoconus.
• To synthesize recent literature and provide expert perspective on managing this condition.

Main Methods:

• Perspective review and synthesis of selected scientific literature.
• Interpretation and expert opinion on the findings.

Main Results:

• Acute hydrops involves corneal edema due to aqueous entering the stroma via a Descemet membrane break.
• Advanced imaging (ultrasound biomicroscopy, OCT, confocal microscopy) reveals microstructural changes and influences management.
• Newer treatments shorten edema duration and improve graft survival after transplantation.

Conclusions:

• Effective management requires recognizing risk factors, prompt treatment of acute events, and successful corneal transplantation.
• Improved in vivo imaging enhances understanding of pathogenesis and ultrastructural changes, leading to better disease management.