Cornea Cases

Title:

Stromal Hydrops – An Atypical Presentation in a Child with Advanced Keratoconus Previously Treated with Corneal Collagen Cross-Linking

Case Report Details

First Author: A.Abraham UK

Co Author(s):    A. Achiron   O. El-Haddad   P. Maghsoudlou   D. Leadbetter   D. Tole   K. Darcy     

Abstract Details

Purpose:

To describe an atypical hydrops variant (stromal hydrops) occurring in a child with progressive keratoconus previously treated with corneal collagen cross-linking (CXL) and managed using compressive corneal suturing.

Setting:

Corneal clinic setting in a specialist ophthalmology hospital in the South West of the United Kingdom (Bristol Eye Hospital).

Report of case or case series:

A fourteen-year-old child with a history of advanced keratoconus treated previously with bilateral CXL presented with a sequential, bilateral acute corneal hydrops. Anterior segment optical coherence tomography (AS-OCT) demonstrated atypical findings bilaterally, with large intra-stromal clefts visible in both affected corneas. Compressive corneal suturing led to intra-stromal cleft closure visible on AS-OCT whilst use of SF6 20% gas injection had no visible effect on the cleft size

Conclusions/Take Home Message:

An atypical variant of hydrops (stromal hydrops) may occur in paediatric patients with advanced progressive keratoconus and previous CXL treatment. Compressive corneal suturing can lead to cleft closure, and should be considered as a treatment option.