Scheimpflug-Based Tomographic Risk Factors for the Development of Acute Corneal Hydrops in Keratoconus

Area of Science:

• Ophthalmology
• Corneal Diseases
• Keratoconus Research

Background:

• Keratoconus is a progressive thinning disorder of the cornea.
• Acute corneal hydrops (ACH) is a rare but serious complication of keratoconus.
• Identifying risk factors for ACH is crucial for patient management.

Purpose of the Study:

• To identify clinical and tomographic risk factors for acute corneal hydrops (ACH) in keratoconus patients.
• To describe the tomographic changes in the cornea over time following ACH.

Main Methods:

• Retrospective review of keratoconus patients from January 2015 to May 2023.
• Comparison of eyes that developed ACH with control eyes having advanced keratoconus (Stage IV).
• Analysis of demographic, clinical, and tomographic factors, including visual acuity, keratometry, and corneal thickness.

Main Results:

• Twenty-three eyes of 19 patients developed ACH.
• Higher incidence of Down syndrome in the ACH group (P=0.04).
• Eyes with ACH had steeper keratometry (P=0.003) and thinner corneas (P<0.001) at baseline.
• Post-ACH, corneal flattening and reduced maximum keratometry were observed.
• Final best-corrected visual acuity was significantly worse after ACH compared to baseline and control eyes (P=0.03 and P<0.001, respectively).

Conclusions:

• Steep keratometry, thin corneas, and Down syndrome are significant risk factors for developing ACH.
• Corneal flattening occurs after ACH resolution, but visual acuity is negatively impacted long-term.