Intracameral air injection for acute hydrops in keratoconus

Abstract

PURPOSE: To evaluate the efficacy and safety of intracameral air injection in treating acute hydrops in keratoconus. DESIGN: Retrospective, nonrandomized, comparative trial. METHODS: PATIENTS: Thirty eyes (30 patients) with acute hydrops secondary to keratoconus. intervention: Nine eyes (nine patients) with acute hydrops in keratoconus were treated with intracameral injection of 0.1 ml filtered air. Additional 0.1 ml filtered air was injected if corneal edema persisted when air disappeared from the anterior chamber. Twenty-one eyes (21 patients) with acute hydrops that received no therapy or conventional therapy not likely to shorten the duration of hydrops served as controls. main outcome measures: The period of persistence of corneal edema, the interval between the onset of acute hydrops, and the time when the eye could begin to wear a hard-contact lens, and best spectacle-corrected and hard-contact lens-corrected visual acuity after corneal edema subsided were used as criteria to evaluate any differences between the two groups. RESULTS: The average period of persistence of corneal edema was 20.1 ± 9.0 days (± SD) in the intracameral air injection group and 64.7 ± 34.6 days in the control ( P = .0008). The average interval between the onset of acute hydrops and the time when the eye could begin to wear a hard-contact lens, was 33.4 ± 5.6 days in the air injection group and 128.9 ± 85.8 days in the control group ( P = .0058). The best-corrected visual acuity after corneal edema subsided was similar between the two groups. Intracameral air injection induced no complications. CONCLUSIONS: The results suggest that the intracameral air injection is a safe and useful therapy to shorten the period of corneal edema in acute hydrops secondary to keratoconus.