Posters

Management of acute corneal hydrops in keratoconus complicated with angle-closure glaucoma

Poster Details

First Author: D. Cordeiro Sousa PORTUGAL

Co Author(s):    N. Ferreira   I. Leal   L. Abegao Pinto   A. Quintas   W. Rodrigues   P. Guerra     

Abstract Details

Purpose:

To report the case of a 41 year-old patient with known stage 4 keratoconus presenting with acute corneal hydrops, which was managed using intracameral gas injection and complicated with angle-closure glaucoma. The risk factors, mechanisms and treatment options of acute corneal hydrops in this setting will be discussed.

Setting:

Outpatient clinic - Ophthalmology, Lisbon Academic Medical Center.

Methods:

Observational case-report study.

Results:

A 41-year-old man with stage-4 keratoconus presented with red eye for 3 days. Observation revealed prominent edema and protrusion of the inferior cornea and an acute inferior corneal hydrops was diagnosed. To manage the acute event, an injection of 0.2 mL of non-expandable SF6 gas (14%) was performed. Approximately 18 hours after this procedure, a secondary acute glaucoma was identified and the gas was partially removed in the operating room. During follow-up, the patient developed symptomatic refractory angle-closure glaucoma with 360º iridocorneal contact. In collaboration with glaucoma department, an Ahmed® valve was implanted and the patient is now waiting for penetrating keratoplasty.

Conclusions:

Even when promptly and properly treated, acute corneal hydrops is a serious complication of keratoconus. Our case highlights the diagnosis and management options of this incompletely understood entity. Newer medical and surgical options should be pursued to reduce sequelae of acute corneal hydrops in keratoconus.

Financial Disclosure:

NONE