Acute hydrops in keratoconus masquerading as acute corneal transplant rejection.

PURPOSE

To document 2 cases that developed acute hydrops corneae within the host tissue after corneal transplantation. Subsequent extension across the transplant-host interface led to edema of the transplanted tissue, with consequent misdiagnosis and treatment of acute transplant rejection.

METHODS

The patients attended the Anterior Segment Service at Moorfields Eye Hospital, London, UK.

RESULTS

Both patients had a reduction in vision, ocular discomfort, and stromal edema of the transplanted button and adjacent host cornea. No break in the Descemet membrane was noted in either case.

CONCLUSION

It is important to differentiate hydrops of the host cornea from acute transplant rejection. This distinction will allow the judicious use of steroids and may allay patient anxiety about possible rejection.