Pneumodescemetopexy with perfluoroethane (C2F6) for the treatment of acute hydrops secondary to keratoconus

To evaluate the efficacy and safety of pneumodescemetopexy with intracameral perfluoroethane (C2F6) gas for the treatment of acute hydrops secondary to keratoconus.

Retrospective, non-comparative, interventional case series. Eight eyes of eight patients who presented with acute hydrops secondary to keratoconus between July 2009 and September 2013 were consecutively recruited. All were treated with intracameral 14% isoexpansile concentration of C2F6. Preoperative and postoperative best-corrected visual acuities (BCVA), intraoperative and postoperative complications, and time taken for resolution of corneal oedema were assessed.

All the patients, except for one, were followed up for 1 year. The mean age of the cohort was 29.1±13.5 years. BCVA at presentation was 6/60 or less in all patients. Improvement of BCVA was achieved postoperatively in seven (87.5%) patients, with three (37.5%) patients achieving a BCVA of 6/18. The average time between initial presentation and complete resolution of corneal oedema was 60.0±32.1 days. The C2F6 gas persisted in the anterior chamber between 6 and 8 days. All the patients required only one injection during the treatment period. There was no intraoperative or postoperative complication noted during the follow-up period.

Pneumodescemetopexy with intracameral isoexpansile concentration of C2F6 gas serves as a safe and effective treatment modality for patients with acute hydrops secondary to keratoconus.