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Intrastromal clefts in keratoconus patients with hydrops
R S Feder1, K R Wilhelmus, S D Vold
1Department of Ophthalmology, Northwestern University Medical School, Chicago, Illinois 60611-2814, USA. r-feder@nwu.edu
American Journal of Ophthalmology
|July 31, 1998
Summary
Intrastromal clefts in acute hydrops keratoconus generally close within months. However, corneal neovascularization is common and may impact future graft survival.
Area of Science:
- Ophthalmology
- Corneal Diseases
- Keratoconus Research
Background:
- Acute hydrops in keratoconus is a vision-threatening complication.
- Intrastromal clefts represent a specific clinical manifestation within acute hydrops.
Observation:
- This study observed nine eyes across eight patients with keratoconus experiencing acute hydrops and intrastromal cleft formation.
- Patient demographics included a mean age of 20 years, with follow-up periods ranging from 2.5 to 21 months.
Findings:
- Complete closure of intrastromal clefts was observed in 89% of eyes within 6 months.
- Corneal stromal neovascularization occurred in 67% of affected eyes.
- Visual acuity remained poor (20/200 or worse) in 67% of untreated eyes, while one bilateral case achieved 20/40 with contact lenses.
Implications:
- Intrastromal clefts are a recognized feature of acute hydrops in keratoconus.
- While clefts typically resolve, the risk of stromal neovascularization necessitates careful monitoring.
- Neovascularization may influence the long-term prognosis and success of corneal transplantation.