• Medientyp: E-Artikel
  • Titel: Acute Hydrops After Bowman Layer Transplantation for Keratoconus May Indicate that Descemet Membrane Rupture Is Secondary to Hydrops
  • Beteiligte: Musayeva, Aytan; Santander-García, Diana; Quilendrino, Ruth; Parker, Jack; van Dijk, Korine; Henrat, Carole; Dapena, Isabel; Binder, Perry S.; Melles, Gerrit R.J.
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2022
  • Erschienen in: Cornea
  • Umfang: 1512-1518
  • Sprache: Englisch
  • DOI: 10.1097/ico.0000000000002920
  • ISSN: 0277-3740
  • Schlagwörter: Ophthalmology
  • Zusammenfassung: <jats:sec> <jats:title>Purpose:</jats:title> <jats:p>The aim of this study was to review the postoperative course and imaging features of 7 eyes that presented with corneal hydrops after Bowman layer (BL) transplantation was performed for advanced keratoconus to determine the potential mechanisms of hydrops formation.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>A retrospective analysis was performed of 7 eyes of 5 patients with advanced keratoconus that underwent midstromal BL transplantation at 2 tertiary referral centers and developed acute corneal hydrops on average 64 (±30) months (range 14–104 months) postoperatively. Corneal tomography and anterior segment optical coherence tomography (AS-OCT) images were reviewed to document the postoperative and posthydrops course.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>For all eyes, the post-BL transplantation course was uneventful until hydrops development. Despite stable postoperative topographies in 5 of 7 eyes, eyes developed hydrops with typical hypodense areas on AS-OCT that were limited to the stromal layers posterior to the BL graft. With AS-OCT (6/7 eyes), 2 eyes showed a break in Descemet membrane, whereas Descemet membrane was intact across the cornea in 2 eyes; in 2 eyes, the images were inconclusive. All patients admitted to continued eye rubbing, and all but 1 had a clinically significant allergy and/or atopic constitution. Most eyes (5/7) showed a relatively quick (visual) recovery within 1 to 4 months after hydrops.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Hydrops formation in keratoconic corneas after midstromal BL transplantation may indicate that a break in Descemet membrane is secondary to hydrops development (and not vice versa). With a midstromal BL graft in situ limiting hydrops dimensions, resolution of the hydrops seemed relatively quick with recovery to prehydrops visual acuity in most eyes.</jats:p> </jats:sec>
  • Beschreibung: <jats:sec>
    <jats:title>Purpose:</jats:title>
    <jats:p>The aim of this study was to review the postoperative course and imaging features of 7 eyes that presented with corneal hydrops after Bowman layer (BL) transplantation was performed for advanced keratoconus to determine the potential mechanisms of hydrops formation.</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>Methods:</jats:title>
    <jats:p>A retrospective analysis was performed of 7 eyes of 5 patients with advanced keratoconus that underwent midstromal BL transplantation at 2 tertiary referral centers and developed acute corneal hydrops on average 64 (±30) months (range 14–104 months) postoperatively. Corneal tomography and anterior segment optical coherence tomography (AS-OCT) images were reviewed to document the postoperative and posthydrops course.</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>Results:</jats:title>
    <jats:p>For all eyes, the post-BL transplantation course was uneventful until hydrops development. Despite stable postoperative topographies in 5 of 7 eyes, eyes developed hydrops with typical hypodense areas on AS-OCT that were limited to the stromal layers posterior to the BL graft. With AS-OCT (6/7 eyes), 2 eyes showed a break in Descemet membrane, whereas Descemet membrane was intact across the cornea in 2 eyes; in 2 eyes, the images were inconclusive. All patients admitted to continued eye rubbing, and all but 1 had a clinically significant allergy and/or atopic constitution. Most eyes (5/7) showed a relatively quick (visual) recovery within 1 to 4 months after hydrops.</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>Conclusions:</jats:title>
    <jats:p>Hydrops formation in keratoconic corneas after midstromal BL transplantation may indicate that a break in Descemet membrane is secondary to hydrops development (and not vice versa). With a midstromal BL graft in situ limiting hydrops dimensions, resolution of the hydrops seemed relatively quick with recovery to prehydrops visual acuity in most eyes.</jats:p>
    </jats:sec>
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