Intraoperative OCT-Guided Pneumodescemetopexy and Corneal Compression Sutures for Extensive Acute Corneal Hydrops
Abstract
ABSTRACT:
Purpose: To highlight the roles of intraoperative optical coherence tomography (iOCT) in managing acute corneal hydrops (ACH) and outcomes of iOCT-guided pneumodescemetopexy and corneal compression sutures.
Methods: This was a retrospective, consecutive, interventional case series of patients with keratoconus who presented with significant ACH and underwent iOCT-guided pneumodescemetopexy (18% sulfur hexafluoride gas) and compression sutures at Birmingham and Midland Eye Centre, UK, between Aug 2023 and May 2025.
Results: Five patients were included; mean age was 32.3±6.6 years old and 3 (60%) were male. The mean follow-up duration was 16.3±5.6 months. At presentation, the mean corrected-distance-visual-acuity (CDVA) was 1.90±0.67 logMAR, central corneal thickness (CCT) was 1187.6±372.6μm, maximal corneal thickness was 1624.0±383.5μm and maximal height and diameter of pre-Descemet layer/Descemet membrane (PDL/DM) detachment was 1014.6±366.4μm and 4456.0±839.4μm, respectively. The surgery successfully achieved complete PDL/DM attachment in all cases, with a mean time from surgery to ACH resolution of 17.8±8.0 days. iOCT successfully visualized the area of PDL/DM break/detachment, revealed the involvement of PDL (evidenced by a persistent taut type 1 DM detachment after gas tamponade), and guided the placement of compression sutures. Compared to preoperative, there was a significant improvement in the mean CDVA (0.52±0.32 logMAR; p=0.014) at last follow-up. One…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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