Management of Acute Corneal Hydrops Secondary to Keratoconus With Intracameral Injection of Sulfur Hexafluoride (SF6)

Abstract

To report the use of sulfur hexafluoride (SF6) gas in the management of corneal edema caused by acute corneal hydrops secondary to keratoconus. Nine eyes with acute hydrops secondary to keratoconus managed by SF6 gas injected into the anterior chamber (group 1) were compared to another 9 eyes that were managed conservatively with conventional medical therapy (group 2). Of 9 eyes in group 1, 3 had 1 injection, 4 had 2 injections, and the remaining 2 had 3 injections into the anterior chamber. All the eyes in group 1 showed an early resolution of corneal edema at 4 weeks. The same was achieved in group 2 at 12 weeks. The central corneal thickness (CCT) in group 1 and group 2 was >1.0 mm at presentation. The CCT at 3 and 12 weeks in group 1 was 0.99 and 0.65 mm, respectively, whereas CCT in group 2 at 3 weeks was >1.0 mm and at 12 weeks was 0.991 mm (P = 0.001). The mean best spectacle-corrected visual acuity (BSCVA) at 12 weeks in group 1 and group 2 was 0.39 and 0.24, respectively (P = 0.016). The results were significant in favor of group 1 over group 2 both in CCT and BSCVA. Early intervention with intracameral SF6 injection is a safe and effective therapy for early reduction of corneal edema in eyes with keratoconus and acute hydrops.