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Acute corneal hydrops in keratoconus

S J Tuft1, W M Gregory, R J Buckley

  • 1Moorfields Eye Hospital, London, UK.

Ophthalmology
|October 1, 1994
PubMed
Summary

Acute corneal hydrops in keratoconus is linked to younger males, advanced ectasia, and allergies. Penetrating keratoplasty is often needed but has higher rejection rates, though some patients regain vision with contact lenses.

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Area of Science:

  • Ophthalmology
  • Corneal Diseases
  • Keratoconus Research

Background:

  • Keratoconus is a progressive thinning of the cornea.
  • Acute corneal hydrops is a sight-threatening complication of keratoconus.
  • Understanding hydrops development and outcomes is crucial for patient management.

Purpose of the Study:

  • To identify clinical factors associated with acute corneal hydrops in keratoconus patients.
  • To evaluate the outcomes of eyes experiencing acute corneal hydrops.
  • To assess the need for and success of penetrating keratoplasty after hydrops.

Main Methods:

  • Retrospective analysis of 5242 eyes with keratoconus.
  • Identification of 147 eyes with acute hydrops.
  • Comparison of clinical features between hydrops and non-hydrops groups.
  • Actuarial analysis of progression to penetrating keratoplasty.

Main Results:

  • Younger males with advanced corneal ectasia and poor visual acuity at keratoconus diagnosis were more prone to hydrops (P < 0.001).
  • Severe allergic eye disease significantly increased hydrops risk (P < 0.001).
  • Hydrops was a strong predictor for penetrating keratoplasty (P < 0.00001); 59% of hydrops eyes underwent surgery.
  • Graft rejection rates were higher in eyes grafted after hydrops (P = 0.02).
  • Among unoperated eyes, 61% achieved 20/40 or better vision with contact lenses post-hydrops resolution.

Conclusions:

  • Penetrating keratoplasty is frequently required for visual rehabilitation after acute corneal hydrops, but carries an increased risk of graft rejection.
  • Contact lens refitting can provide functional visual acuity in some patients, potentially delaying or avoiding surgery.
  • Close monitoring and management are essential for patients experiencing acute corneal hydrops.

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