PDF(Pubmed)
Abstract：
BACKGROUND Acute corneal hydrops, a rare complication of keratoconus, is characterized by sudden onset of corneal stroma edema. It typically manifests as an acute decrease in visual acuity, accompanied by pain and photophobia. Prompt recognition and interventions are critical for effective resolution of hydrops and prevention of corneal vascularization. Herein, we present a case of a patient with keratoconus who developed corneal hydrops, successfully managed using full-thickness compression sutures and intracameral air injection. CASE REPORT A woman in her early 30s, with a history of keratoconus, presented with symptoms of acute hydrops in her left eye. On presentation, best corrected visual acuity was hand motion. Slit-lamp examination revealed marked corneal edema with multiple stromal clefts. The decision was made to perform full-thickness compression sutures combined with intracameral air injection to expedite edema resolution and prevent neovascularization. Three full-thickness sutures were placed across Descemet membrane breaks, and an air bubble was left, filling 50% of the anterior chamber. At 3-month follow-up, a clear, compact cornea was noted, with no evidence of vascularization. The patient was scheduled for penetrating keratoplasty for visual rehabilitation. CONCLUSIONS The combination of full-thickness compression sutures and intracameral air seems to be an effective and safe method for preventing corneal angiogenesis following hydrops. As corneal scaring is often an inevitable complication of acute corneal hydrops, keratoplasty is necessary for improving visual acuity. Hence, the prevention of corneal vascularization should be the major aim in the management of corneal hydrops to ensure successful keratoplasty.
摘要：
背景技术急性角膜积液,一种罕见的圆锥角膜并发症,以突然发作的角膜基质水肿为特征。通常表现为视力急性下降，伴有疼痛和畏光。及时识别和干预对于有效解决积水和预防角膜血管形成至关重要。在这里，我们介绍了一例圆锥角膜患者出现角膜积液，使用全层加压缝线和前房内空气注射成功管理。案例报告一个30岁出头的女人,有圆锥角膜病史,她的左眼出现急性水肿的症状.在介绍时，最佳矫正视力是手部动作。裂隙灯检查显示明显的角膜水肿并伴有多个基质裂隙。决定进行全层加压缝线结合前房内空气注射，以加快水肿消退并防止新生血管形成。在Descemet膜断裂上放置了三个全厚度缝线，留下了一个气泡，填充50％的前房。在3个月的随访中，一个明确的,注意到紧凑的角膜，没有血管化的证据.患者计划进行穿透性角膜移植术以进行视觉康复。结论全层加压缝线和前房内空气的组合似乎是预防水肿后角膜血管生成的有效和安全的方法。由于角膜惊吓通常是急性角膜积液的不可避免的并发症，角膜移植术对于提高视力是必要的。因此，预防角膜血管化应该是治疗角膜积液的主要目标，以确保角膜移植术成功。
