Relaxing descemetotomy with compression sutures for management of acute hydrops in post-LASIK ectasia

A woman in her 40s having post-laser-assisted in situ keratomileusis (LASIK) ectasia in both eyes developed acute hydrops in her right eye 19 years after LASIK. Anterior segment optical coherence tomography (ASOCT) did not reveal any Descemet's membrane break, which is usually present in acute hydrops. Corneal oedema was not resolved with conservative management, so descemetopexy with perfluoropropane (C3F8) gas was performed. Despite the descemetopexy with C3F8 gas, worsening of the corneal oedema was noted. In view of the non-resolving acute hydrops even after conventional treatment, a relaxing descemetotomy and full-thickness venting incision with descemetopexy and compression sutures were planned. The complete resolution of corneal oedema with a good visual outcome was achieved using this novel technique.