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Acute Corneal Hydrops Complicated by Microbial Keratitis: Case Series Reveals Poor Immediate and Long-Term Prognosis

Jay J Meyer1, Charles N J McGhee

  • 1Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

Cornea
|May 19, 2016
PubMed
Abstract

Insights

Microbial keratitis is a rare but serious complication of acute corneal hydrops, especially in contact lens wearers. Prompt treatment is crucial to prevent vision loss and preserve corneal health.

Area of Science:

  • Ophthalmology
  • Corneal Diseases

Background:

  • Acute corneal hydrops is a rare complication of keratoconus.
  • It can be a risk factor for severe ocular complications.

Observation:

  • This retrospective case series analyzed six eyes that developed microbial keratitis during acute corneal hydrops.
  • Identified risk factors included epithelial defects, contact lens wear, trichiasis, and topical steroid use.

Findings:

  • Microbial keratitis during acute corneal hydrops led to significant scarring, neovascularization, and vision loss (20/200 or less).
  • Complications included corneal perforation and possible endophthalmitis.
  • Penetrating keratoplasty was performed in three eyes, with one experiencing graft failure due to endothelial rejection.

Implications:

  • Microbial keratitis can rapidly progress during acute corneal hydrops, leading to irreversible vision impairment.
  • The infection can compromise outcomes of subsequent corneal transplantation.
  • Prophylactic topical antibiotics are recommended for patients with acute corneal hydrops.

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