Department of Ophthalmology, All India Institute of Medical Sciences, Rajkot, Gujarat, India.
Buddha Eye Clinic and Laser Centre, Patna, Bihar, India.
Indian J Ophthalmol. 2022 Jun;70(6):2210. doi: 10.4103/ijo.IJO_1258_22.
Acute corneal hydrops is a vision threatening complication of corneal ectasia like keratoconus, keratoconus, keratoglobus, Pellucid marginal degeneration, Terrien's marginal degeneration and post refractive surgery keratectasia. The associated risk factors for development of corneal hydrops (CH) are early onset of keratoconus, microtrauma associated with contact lens use, eye rubbing, allergic conjunctivitis, atopy, and Down's syndrome. With the conservative approach of management of CH, it takes longer time (in months) for corneal oedema to get resolved and there is development of vascularization and scarring. This video presents the simple technique of using compression sutures along with pneumodescemetopexy by intracameral air injection for management of CH. It led to rapid resolution of corneal oedema. It is a simple technique, with no need of special gases like C3F8 or SF6 and can be easily performed at a very basic set up.
To highlight the efficacy of simple technique of applying compression sutures and air tamponade in management of CH and to demonstrate the efficacy of anterior segment OCT in diagnosis and to assess the prognosis of a case of CH.
A 9-year-old boy presented with CH, with anterior segment OCT showing torn descemet's membrane and fluid pockets in corneal stroma. Four full-thickness compression sutures were applied and intracameral sterile air was used for pneumodescetopexy. The serial post operative clinical and OCT picture showed rapid resolution of corneal oedema. Highlights: This video highlights the use of OCT imaging in the diagnosis of CH and full-thickness compression sutures as the safe and effective technique in the management of acute CH.
急性角膜水肿是角膜扩张症（如圆锥角膜、球形角膜、边缘性角膜变性、Terrien 边缘性变性和屈光手术后角膜扩张症）的一种威胁视力的并发症。角膜水肿（CH）发生的相关危险因素有：圆锥角膜的早期发病、接触镜使用相关的微创伤、揉眼、过敏性结膜炎、特应性和唐氏综合征。对于 CH 的保守治疗方法，角膜水肿需要更长的时间（以月计）才能消退，并且会发生血管化和瘢痕形成。本视频介绍了一种简单的技术，即在眼内注入空气行房水内打气式黏弹剂前房内填充的同时，使用加压缝线治疗 CH。该技术可迅速消退角膜水肿。这是一种简单的技术，不需要 C3F8 或 SF6 等特殊气体，并且可以在非常基本的设备上轻松进行。
强调应用加压缝线和空气填塞治疗 CH 的简单技术的疗效，并展示前节 OCT 在诊断中的作用，并评估 CH 病例的预后。
一名 9 岁男孩因 CH 就诊，前节 OCT 显示撕裂的后弹力层和角膜基质中的液袋。应用了 4 条全层加压缝线，并在眼内注入无菌空气行房水内打气式黏弹剂前房内填充。术后系列临床和 OCT 图片显示角膜水肿迅速消退。重点：本视频重点介绍了 OCT 成像在 CH 诊断中的应用，以及全层加压缝线作为治疗急性 CH 的安全有效的技术。
